Do Everyday Problems of People With Chronic Illness Interfere With Their Disease Management?

Lieke van Houtum; Mieke Rijken; Peter Groenewegen


BMC Public Health. 2015;15(1000) 

In This Article


Description Study Sample

The mean age of the study sample was 61.8 years (SD 14.3) and 54 % of the respondents were female. Cardiovascular disease (26 %), COPD (22 %) and asthma (20 %) were the most common chronic diseases within the sample. Half of the study sample (48 %) was diagnosed with more than one chronic (somatic) disease. The mean perceived health score of the study sample was 52.8, which is substantially lower than the mean score found in general population samples.[26] Forty-one percent of the respondents had no physical limitations, 29 % mild limitations, 22 % moderate and 8 % severe limitations.

Problems in Everyday Life

A third (37 %) of the respondents reported recently experiencing one or more problems in their everyday lives. Twenty percent of the study sample encountered basic problems and 28 % social problems (Table 1). Only 11 % of the respondents had basic problems as well as social problems. Sexual (14 %) or financial (12 %) problems were mentioned most often.

Both types of everyday problems were negatively associated with age and perceived health (Table 2). These associations indicate that the older people are, or the higher they rate their general health, the less likely it is that they encounter basic and social problems in their everyday life. In addition, respondents who experienced (mild, moderate or severe) physical limitations had significantly higher odds of having everyday problems than people who did not experience physical limitations, except for respondents with severe physical limitations regarding having basic problems.

Everyday Problems and Self-management

Chronically ill people with basic or social problems reported lower levels of self-management than people who did not have everyday problems (Table 3 and Table 4). Adjusting for covariates reduced the differences between the two groups, although some differences remained significant. Regarding basic problems, there was no difference in symptom management (hypothesis 1) and active involvement in treatment (hypothesis 2) between people who have basic problems and people who do not have basic problems. However, people who experienced basic problems were less actively coping with the consequences of their illness than people who did not have those problems (hypothesis 3). Regarding social problems, people who experienced social problems had a lower level of symptom management (hypothesis 1) and were also less active in coping (hypothesis 3). There were no differences between people who had social problems and those who did not regarding symptom management (hypothesis 2).

The sensitivity analyses show similar results (Appendix 1 and Appendix 2). We also found that having both basic and social problems had an interaction effect on coping (Appendix 3). This indicates that the negative association of having basic or social problems with the level of coping was stronger when people had both basic and social problems. An interaction effect was not found for the other two domains of self-management.