Self-management by Hospitalized Older Adults Based on Self-regulation: a Structural Equation Model

Abstract

Background: Based on the common-sense model of self-regulation, this study aimed to examine the process of self-management through the proposed framework of “Self-system (type D personality)”→ “Cognitive illness perception,” “Emotional illness perception (Depression)”→ “Coping strategies (Approach coping)”→ “Illness Appraisal (Self-management),” using a structural equation model.Methods: The study was conducted at two care hospitals with 300 or more beds located in Jeolla Province, South Korea. The participants were 287 hospitalized older adults. The data collection period was February 17–March 10, 2021. The data were analyzed using SPSS WIN 23.0 and AMOS 23.0. To investigate the overall relationships among the factors influencing self-management among participants, a hypothetical model was created based on the common-sense model of self-regulation. The fit of the model and significance of its paths were analyzed. Results: The hypothetical model showed a good fit based on the following results: CMIN/DF(Q)=2.852, CFI=.955, TLI=.947, and RMSEA=.08. Type D personality had a significant direct effect on cognitive illness perception (β=-.491, p<.001) and depression (β=.844, p<.001). Cognitive illness perception (β=.650, p<.001) and depression (β=-.433, p<.001) had a direct effect on approach coping. Approach coping (β=.326, p<.001) had a direct effect on self-management. Notably, approach coping mediated illness perception and self-management. The explanatory power of the variables for self-management was 78.8%.Conclusion: These findings demonstrated the following mechanism: “type D personality” → “cognitive illness perception” and “depression” → “approach coping” → “self-management,” and highlighted the potential threat of type D personalities and depression on self-management. Cognitive illness perception and approach coping both contribute toward older adults’ self-management.

Intertemporal decision-making as a mediator between personality traits and self-management in type 2 diabetes: a cross-sectional study

“…There are several other factors that may contribute to these associations, including cognitive and emotional illness perception, and coping strategies. For instance, a study conducted by Kim et al (2021) highlighted the significant influence of 'Type D personality' , 'cognitive illness perception' , 'emotional illness perception (Depression)' , and 'coping strategies (Approach coping)' on selfmanagement behavior. In addition, consideration of environmental stressors may also contribute to these associations.…”