Self-Management Ability and Its Associations with Pruritus Severity, Self-Perceived Burden, and Psychological Resilience in Adults with Atopic Dermatitis: A Cross-Sectional Study.

OBJECTIVE: To evaluate self-management ability among adults with atopic dermatitis (AD) and examine its associations with pruritus severity, self-perceived burden, and psychological resilience. METHODS: This cross-sectional study included 585 adults with AD. Self-management, pruritus, self-perceived burden, and psychological resilience were assessed using the Chronic Disease Self-Management Study Measures (CDSMS), pruritus Numerical Rating Scale (NRS), Self-Perceived Burden Scale (SPBS), and Connor-Davidson Resilience Scale (CD-RISC), respectively. The CDSMS total score was the primary outcome; its two subscale scores were secondary outcomes, and the three behavioral domain scores were exploratory outcomes. Univariable and multivariable linear regression analyses were used to estimate associations. RESULTS: The mean CDSMS total score was 62.53 ± 9.55. In the primary multivariable model, older age (β=-0.06, 95% CI -0.11 to -0.02; P=0.003) and greater self-perceived burden (β=-0.23, 95% CI -0.35 to -0.11; P<0.001) were associated with lower CDSMS scores, whereas greater psychological resilience was associated with higher scores (β=0.30, 95% CI 0.21 to 0.39; P<0.001). Pruritus showed a borderline inverse association (β=-0.44, 95% CI -0.87 to 0.00; P=0.050). Alcohol use, pruritus, and physical and emotional burden were associated with lower self-efficacy, whereas optimism and tenacity were associated with higher self-efficacy. Older age and being single were associated with poorer self-management behaviors; estimates for divorced and widowed participants were based on very small subgroups and were considered exploratory. Associations varied across the cognitive symptom management, physician communication, and exercise domains. CONCLUSION: Among adults with AD, poorer overall self-management was associated with older age and greater self-perceived burden, whereas greater psychological resilience was associated with better self-management. Associations differed across self-efficacy, overall self-management behaviors, cognitive symptom management, communication with physicians, and exercise. Assessment of pruritus, perceived burden, coping resources, communication difficulties, and age-related barriers may help tailor self-management support; longitudinal and intervention studies are needed to determine whether such support improves outcomes.