title: Self-management support needs of patients with chronic illness: do needs for support differ according to the course of illness?
abstract: OBJECTIVE
  To determine whether chronically ill patients' needs for self-management support depend on their course of illness.
  
  
  METHODS
  Cross-sectional and longitudinal linear regression analyses were conducted using data from 1300 patients with chronic disease(s) who participated in a nationwide Dutch panel-study. Self-management support needs were assessed by the Patient Assessment of Self-management Tasks questionnaire (PAST). Course of illness was operationalized as: illness duration, patients' perception of the course of illness and changes in self-rated general health (RAND-36).
  
  
  RESULTS
  Self-management support needs are not related to illness duration. Patients who perceive their illness as episodic and/or progressively deteriorating have greater self-management support needs than patients who perceive their illness as stable. Deterioration of self-rated health is related to increased support needs. The effect of the course of illness on support needs depends on the type of self-management activities.
  
  
  CONCLUSIONS
  How chronically ill patients perceive the course of illness and actual changes in self-rated health are predictive for their need for support for self-management activities. Illness duration is not.
  
  
  CONCLUSIONS
  Helping patients to self-manage should not be confined to the first years after diagnosis. Healthcare providers should be alert to patients' own perceptions of their course of illness and health status.
authors.affiliation: NIVEL - Netherlands Institute for Health Services Research, Utrecht, The Netherlands. Electronic address: l.vanhoutum@nivel.nl.
authors.forename: Lieke
authors.initials: L
authors.lastname: van Houtum
authors.forename: Mieke
authors.initials: M
authors.lastname: Rijken
authors.forename: Monique
authors.initials: M
authors.lastname: Heijmans
authors.forename: Peter
authors.initials: P
authors.lastname: Groenewegen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000628:therapy*; D003430:Cross-Sectional Studies; D005260:Female; D006301:Health Services Needs and Demand; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009426:Netherlands; D010361:Patients / Q000523:psychology*; D011787:Quality of Health Care / Q000458:organization & administration; D012044:Regression Analysis; D012648:Self Care / Q000379:methods; D057566:Self Report; D012944:Social Support; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Chronic illness; Course of illness; Patients; Self-management; Support need