Latent profiles of self-management behavior and associated factors among Chinese patients with ulcerative colitis

Ulcerative colitis (UC) poses a growing clinical and socioeconomic burden in China. Effective self-management is critical for long-term disease control, yet significant heterogeneity exists in self-management behavior (SMB) among patients. This study aimed to identify latent profiles of SMB and examine associated factors among patients with UC.

In this cross-sectional study, 415 UC patients completed validated measures including the IBD Self-management Scale (36 items, 7 domains), the Connor-Davidson Resilience Scale-10 (CD-RISC-10), Patient Health Questionnaire-9 (PHQ-9), Family Communication subscale of the Family Assessment Device, and Social Support Rating Scale (SSRS). Latent profile analysis (LPA) was used to identify distinct SMB patterns. Multinomial logistic regression (R3STEP procedure) examined factors associated with profile membership, with the largest class (Low-Monitoring) as the reference.

Three latent profiles were identified: Low-Monitoring (53.97%), characterized by poor symptom surveillance and exercise management; Emotion-Adaptive (37.11%), with strong emotion regulation but limited resource utilization; and High-Engagement (8.92%), demonstrating balanced and proactive self-management across domains. Compared with the Low-Monitoring group, patients in the Emotion-Adaptive and High-Engagement profiles had significantly higher social support (OR = 1.054 and 1.102, respectively; both p < 0.01) and lower depressive symptoms (OR = 0.856 and 0.539, respectively; both p < 0.01). High-Engagement members also showed higher psychological resilience (OR = 1.112, p = 0.009) and better family communication (OR = 1.466, 95% CI: 0.985 2.181, p = 0.049), although the latter association was of borderline statistical significance. Rural residence, middle income, and being in clinical remission were associated with lower odds of belonging to more engaged profiles.

Despite the single-center design and a predominantly hospitalized cohort limiting generalizability to outpatient or community populations, this study characterizes the heterogeneity of self-management behavior (SMB) among Chinese patients with UC through latent profile analysis, identifying a behavioral typology that provides a descriptive framework for understanding patient-reported outcomes.