Multiple illness perceptions and self-management in older adults with concurrent coronary heart disease and diabetes mellitus: A moderation analysis.

BACKGROUND: Previous studies on the association between illness perception and self-management have mainly focused on patients with a single illness. Nevertheless, most adults over 60 years suffer from multimorbidity. OBJECTIVE: To 1) explore the associations between multiple illness perceptions and self-management in the context of multimorbidity, 2) examine the moderation effects of multiple illness perceptions. METHODS: A cross-sectional study was conducted from Dec 2022 to Mar 2023. A total of 210 older adults aged ≥60 years with CHD and DM were recruited from the cardiovascular ward of two tertiary hospitals in Guangzhou, China. Data were collected using the Brief Illness Perception Questionnaire, the Coronary Artery Disease Self-management Scale, and the Diabetes Self-care Scale. Pearson correlation analysis and hierarchical linear regression analysis were used for data analysis. RESULTS: Illness perceptions of CHD and DM were correlated with self-management of CHD (|r|=0.136∼0.424, P < 0.05) and DM (|r|=0.146∼0.484, P < 0.05), respectively. Identity of DM moderates the association between identity of CHD and daily life management of CHD (P < 0.05). Coherence of CHD moderates the relationship between coherence of DM and medication adherence of DM (P < 0.05). CONCLUSIONS: Rather than focusing on single-disease education, healthcare providers could develop integrated psycho-educational programs that concurrently target illness perceptions of CHD and DM, thereby optimizing multimorbidity self-management in older adults with both conditions.