title: Much to be desired in self-management of patients with adrenal insufficiency.
abstract: We assessed self-management in patients with adrenal insufficiency and patient-related factors that affect self-management. A self-report questionnaire was developed to assess self-management. The questionnaire contained three main topics, including: (i) medication adherence; (ii) anticipated measures; and (iii) dose adaptation during medical emergencies. Sixty per cent of the patients (n = 116) completed the questionnaire. The score for the medication adherence was 3.5 out of 4. The score for anticipated measures was 3.4 out of 5, and dose adaptation during medical emergencies was 1.9 out of 3. Older age was a positive predictor for all three self-management topics. The female sex was a positive predictor for anticipated measures and dose adaptation during medical emergencies. High education level was associated with higher scores on dose adaptation during medical emergencies in women, not in men. Education level did not affect other self-management aspects. There seems to be a need to improve self-management in these patients. Self-management might be improved by continuous education, and involvement of endocrine nurses and nurse practitioners is likely to be a key factor in the effectiveness of patient education.
authors.affiliation: Department of Medicine, Section of Endocrinology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Judith P
authors.initials: JP
authors.lastname: van Eck
authors.affiliation: School of Health Care Studies, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands.
authors.forename: Robbert J
authors.initials: RJ
authors.lastname: Gobbens
authors.affiliation: Department of Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Joke
authors.initials: J
authors.lastname: Beukers
authors.affiliation: Department of Medicine, Section of Endocrinology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Wanda
authors.initials: W
authors.lastname: Geilvoet
authors.affiliation: Department of Medicine, Section of Endocrinology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Aart-Jan
authors.initials: AJ
authors.lastname: van der Lely
authors.affiliation: Department of Medicine, Section of Endocrinology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Sebastian J C M M
authors.initials: SJ
authors.lastname: Neggers
mesh_terms: D000309:Adrenal Insufficiency / Q000523:psychology* / Q000628:therapy*; D001294:Attitude to Health; D005260:Female; D006266:Health Education / Q000458:organization & administration; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010349:Patient Compliance; D012648:Self Care; D057566:Self Report; D012737:Sex Factors; D011795:Surveys and Questionnaires
keywords: adrenal insufficiency; endocrine nurses; knowledge; self-management and patient education