Chronic Patients’ Activation and Its Association with Stress, Anxiety, Depression, and Quality of Life: A Survey in Southeast Iran

Abstract

A better perception of the factors associated with patient activation, as a way to improve self-management, is the most important step in planning patient-centered education for chronic disease management. Therefore, the present study is aimed at investigating the relationship between activation, stress, anxiety, depression, and quality of life (QOL) in patients with chronic diseases. This correlational study was performed on 293 chronic patients admitted to coronary care units (CCUs) in one of the hospitals in Rafsanjan. The Patient Activation Measure (PAM), Quality of Life-BREF (WHOQOL-BREF), and Depression, Anxiety, and Stress Scale-21 Items (DASS-21) were used to collect data. The data were then analyzed using SPSS 22. A significant positive correlation was observed between general QOL and PAM ( $P<0.001$ ). In addition, a significant negative correlation was found between PAM, stress ( $P=0.032$ ), and depression ( $P=0.025$ ). The results of multivariate linear regression indicated that only physical and psychological subscales of QOL significantly predicted PAM ( $B=0.24$ ; 95% confidence interval; $P$ value < 0.05). Owing to the fact that some subscales of QOL have a determinant role in the PAM of chronic patients, healthcare providers are recommended to plan and implement the necessary interventions to improve the QOL and the health outcomes of chronic patients.