AB1022 FACTORS AFFECTING PATIENT ACTIVATION AMONG PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS: A MULTI-GROUP PATH ANALYSIS ACCORDING TO DISEASE ACTIVITY
Authors: Y. Song, Z. Wang, L. Ou, D. Liao, L. He, Q. Ning, Y. Chen, H. Chen
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Systemic lupus erythematosus (SLE) is a chronic condition characterized by multisystem involvement and recurrent relapses [1]. Efforts should be made to help SLE patients manage disease better. Concerning the contribution of patient activation to self-management and health-related outcomes, it is vital to understand the status of patient activation. Besides, disease activity can affect patient's perception of condition and further impact patient activation. However, little is known about patient activation among SLE patients and how disease activity affects patient activation [2]. <h3>Objectives:</h3> To investigate the patient activation in SLE patients and to explore the pathways of its influencing factors on patient activation and the moderating effect of disease activity on patient activation by multi-group analysis. <h3>Methods:</h3> A cross-sectional study was conducted from June to December 2021 among SLE patients (n=426) of a rheumatology and immunology clinic of a tertiary hospital in Chengdu, China. Patient activation was assessed by the Chinese version of a 13-item Patient Activation Measure. Data on general information, disease activity, quality of chronic illness care, health literacy, self-efficacy, motivation, and social support were collected as influencing factors. The patient activation model was constructed according to the conceptual model based on the individual and family self-management theory through path analysis. To evaluate the moderating effect of disease activity on pathways of patient activation model, participants were divided into two subgroups (low disease activity group and high disease activity group) following K-means cluster analysis [3]. <h3>Results:</h3> The mean score of patient activation in SLE patients was 63.28±11.82, which was at the third level, indicating that most SLE patients lacked the skills and confidence to stick with health-promoting behaviors. The model fit indicators of the patient activation model were all good. Health literacy, social support, and self-efficacy had the greatest effect on patient activation, followed by autonomous motivation, amotivation, and quality of chronic illness care. In the multi-group analysis, social support and health literacy contributed more to patient activation in SLE patients with high and low disease activity, respectively (Figure 1). <h3>Conclusion:</h3> The patient activation of all the SLE patients was at the third level, suggesting that medical personnel in China should supervise patients to adhere to the health promotion behaviors they have adopted. Health literacy, social support, and self-efficacy were vital variables affecting patient activation in SLE patients. Hierarchical strategies should be developed to improve these factors according to the level of disease activity and ultimately increase patient activation and health outcomes of SLE patients. <h3>REFERENCES:</h3> [1] Fanouriakis, A. et al. 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus. Ann. Rheum. Dis. 2019;78(6), 736-45. [2] Fortin, P. R. et al. Challenges of Perceived Self-Management in Lupus. Arthritis Care Res(Hoboken). 2022;74(7), 1113-21. [3] Igartua, J. J., Hayes, A. F. Mediation, Moderation, and Conditional Process Analysis: Concepts, Computations, and Some Common Confusions. Span. J. Psychol. 24, e49 (2021). <h3>Acknowledgements:</h3> We would like to thank all participants and those who assisted with this study. <h3>Disclosure of Interests:</h3> <b>None declared.</b>