Self-management behaviors in patients with epilepsy: A dual-process model

Effective self-management is essential for patients with epilepsy to achieve optimal health outcomes. However, previous studies indicate that self-management performance remains suboptimal in this population. This study aimed to evaluate the relationships between patient empowerment, disease-related fear, self-regulatory fatigue, and self-management behaviors in patients with epilepsy in China, utilizing dual systems theory as a framework.

A convenience sampling method was employed to collect data from 655 patients with epilepsy at a tertiary hospital in Hangzhou, China, between June and November 2023. Validated scales were used to assess patient empowerment, disease-related fear, self-regulatory fatigue, and self-management behaviors. A structural equation model (SEM) based on dual systems theory was used for data analysis.

Among the included patients, 377 (57.60 %) were male, 360 (55.00 %) were from urban areas, and 361 (55.11 %) were unmarried.The average score for self-management behavior was 122.91 ± 18.48, indicating a moderate level of performance. SEM analysis revealed that patient empowerment had a direct positive effect on self-management behaviors (β = 0.236), a direct negative effect on illness-related fear (β = -0.608) and self-regulatory fatigue (β = -0.561), and an indirect effect on self-management behaviors (β = 0.433). All path coefficients were statistically significant (p < 0.0001). The model demonstrated excellent fit indices: χ2/df = 1.422, RMSEA = 0.025, GFI = 0.954, AGFI = 0.954, CFI = 0.952, TLI = 0.959, NFI = 0.954, IFI = 0.925.

The results of structural equation modeling show that the impact of patient empowerment on self-management is mediated through disease-related fear and self-regulatory fatigue. Therefore, enhancing patient empowerment and reducing patients' disease-related fear and self-regulatory fatigue may help promote effective self-management in patients with epilepsy.

Not applicable.