Self-Management Behaviours in Rheumatoid Arthritis Patients: What Role Do Health Beliefs Play?

Purpose: Self-management is the intrinsically controlled ability of an active, responsible, informed and autonomous individual to live with the medical, role and emotional consequences of his chronic conditions in partnership with his social network and the healthcare providers. This study evaluated the self-management behaviours of patients with rheumatoid arthritis and assess the association between health beliefs and self-management behaviours.

Methods: This cross-sectional study investigated 269 rheumatoid arthritis patients' self-management behaviours using the Self-Care Behaviours Scale with a score of 0-4 for each item and a total score of 0-100 points, and health beliefs using the Arthritis Health Belief Inventory with a score of 1-5 for each item and a total score of 0-165 points. Structural equation modelling with maximum likelihood method was used to explore the mediating effect of health beliefs.

Results: The patients' mean score for self-management behaviours was at the intermediate level (2.49 ± 0.60). Sex, marital status, per capita monthly income, payment of medical expenses, social status, disease staging, duration of morning stiffness, joint pain score, treatment, receiving health education, perceived severity, perceived benefits, cue to action and health motivation were significant predictors of the average score of self-management behaviour of the rheumatoid arthritis patients. Perceived severity, perceived benefits, cues to action and health motivation directly affected self-management behaviours; perceived severity influenced self-management behaviours through the mediating effect of cues to action; and health motivation affected self-management behaviours through the chain mediating effect of perceived benefits and cues to action.

Conclusion: Self-management behaviour of rheumatoid arthritis patients was at a moderate level, and health beliefs can effectively explain the differences in self-management behaviour scores. Health providers should pay attention to patients with different sociodemographic characteristics and disease-related characteristics, evaluate their health belief level, and develop targeted intervention measures to further improve patients' self-management behaviour level and improve their disease prognosis.