Mental well-being and patient activation during the first eight months of the COVID-19 pandemic in Denmark - a cohort study among 710 Danish adults with chronic conditions

• Published in: BMC public health 2023-08, Vol.23 (1), p.1472-1472, Article 1472
• Main Authors: Nielsen, Berit Kjærside, Nielsen, Pernille Bjørnholt, Mejdahl, Caroline Trillingsgaard, Nielsen, Lise Arnth, Nielsen, Camilla Palmhøj, Maindal, Helle Terkildsen, Wolf, Michael
• Format: Article
• Language: English
• Subjects: Adult; Adults; Analysis; Bivariate analysis; Cardiovascular diseases; Chronic conditions; Chronic diseases; Chronic illnesses; Cohort analysis; Cohort Studies; Coronary artery disease; Coronaviruses; COVID-19; COVID-19 - epidemiology; Denmark - epidemiology; Diabetes mellitus; Education; Educational attainment; Evaluation; Female; Health behavior; Health education; Health services; Heart diseases; Humans; Loneliness; Lung cancer; Lung diseases; Male; Mental depression; Mental health; Middle Aged; Obstructive lung disease; Outbreaks; Pandemics; Patient activation; Patient Participation; Patients; Prevention; Prospective Studies; Questionnaire study; Questionnaires; Regression models; Risk factors; Sociodemographics; Variables; Viral diseases; Well being
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-023-16316-0

COVID-19 has highlighted the importance of patient activation in managing chronic conditions and promoting resilience during times of crisis. Patient activation refers to an individual's knowledge, skills, and confidence in managing their own health and healthcare. Previous research has shown that people with higher levels of patient activation are better prepared to navigate the challenges of chronic illness and are more likely to engage in healthy behaviors. However, the impact of patient activation on COVID-19-related concerns and mental well-being among people with chronic conditions during the pandemic remains unclear. This study aims to investigate the possible role of patient activation in shaping COVID-19-related concerns and to describe changes in mental well-being among Danish adults with one or more chronic conditions during the early months of the pandemic. Danish adults with chronic conditions (e.g. diabetes, coronary heart disease, obstructive pulmonary lung disease, cancer) who had participated in a municipal health education program prior to the COVID-19 outbreak were asked to participate in this prospective questionnaire study in May 2020 and November 2020. Sociodemographic (sex, age, living status, educational attainment, employment status) and disease-related information (diagnosis, one or more chronic conditions) along with the Patient Activation Measure were collected before the outbreak and were obtained from a clinical database used for monitoring and evaluation of municipal health education programs. In contrast, the two questionnaires collected six months apart consisted of single items related to concerns about COVID-19 and the WHO-5 well-being index. A total of 710 people with chronic conditions (mean age 60.9 years; 55.8% female) participated at both time points. In bivariate analyses, patient activation was associated with COVID-19-related concern and well-being. At follow-up, participants experienced a significant decrease in well-being. The decrease was associated with poorer well-being measured six months earlier, a greater perception that it had become more challenging to take care of one's health due to the pandemic, and finally, feeling lonely. The association between patient activation and well-being ceased to be significant in the multivariate regression model. A considerable proportion of people with chronic conditions participating in this study have been mentally burdened during COVID-19. Although lower levels of pat