The Determinants of Living with Long-Term Conditions: An International Cross-Sectional Study

Abstract

It is essential that healthcare and social professionals understand the daily lives of people with chronic diseases, and the variables that influence them. The aim of this study was to identify the determinants influencing the process of living with long-term conditions. To investigate this, an observational, international, cross-sectional study was carried out. A consecutive sample of 1788 Spanish-speaking population living with chronic obstructive pulmonary disease, chronic heart failure and type 2 diabetes mellitus were included. Descriptive statistics and multiple linear regression models were performed. The linear regression models identified that social support (β = 0.39, p < 0.001) and the satisfaction with life (β = 0.37, p < 0.001) were the main determinants in the process of living with a long-term condition (49% of the variance). Age (β = −0.08, p = 0.01) and disease duration (β = 0.07, p = 0.01) were determinants only in the chronic heart failure subgroup, and country was significant in the chronic obstructive pulmonary disease subgroup (β = −0.15, p = 0.002). Satisfaction with life and social support were key determinants influencing the process of living with long-term conditions. As such, those aspects should be included in the design of interventions focused on the achievement of a positive living in people with long-term conditions.

The Influence of Social Support in PROMs of Patients with COPD in Primary Care: A Scoping Review

“…Self-efficacy and self-care behavior, including adherence, showed consistent improvement when participants reported greater social support in six articles [19,28,[30][31][32]35]. In a qualitative study, Chen et al demonstrated a positive association between social support and self-management [28].…”

“…Patients who received sufficient support from people with whom they had close relationships exhibited a positive correlation with better mental health, although this correlation was no longer present one year after a COPD-specific patient education program [27]. Also, social support was related to better reported general and emotional health and well-being in people [31].…”

“…Four articles [26,27,31,33] were identified that reported a positive impact of social support on mental well-being, specifically on depressive symptoms (2 articles), anxiety (1 article), and psychological well-being (1 article) in patients with COPD. Arabyat et al indicated in their unadjusted analysis of a large U.S. population-based health survey that a reduced level of social/emotional support was associated with a greater likelihood of experiencing depressive symptoms [26].…”

“…The greater the level of social support received by individuals, the more effective their coping mechanisms became [19]. The Duke-UNC Functional Social Support questionnaire identified social support as a significant factor in the process of living with the illness, as evaluated by the Living with Chronic Illness Scale (LW-CI Scale), which encompasses acceptance, coping, self-management, integration, and adjustment [31]. One additional article [30] found that participants with a spouse or partner as their caregiver had 11 times higher odds of participating in a pulmonary rehabilitation program than those without a caregiver.…”

“…The evidence on the relationship between social support and the variables of functional status, quality of life, and self-rated health was inconclusive, and different articles reported different results (8 articles) [19,[26][27][28][31][32][33][34]. The research conducted by Arabyat et al [26] on a community sample of 1.261 patients with COPD revealed a significant correlation between insufficient social/emotional support and disability, as well as impairment in all aspects of health-related quality of life (HRQoL).…”