Potential profiling of self-management skills in older co-morbid patients – BMC Geriatrics

General information questionnaire

A general information questionnaire was designed based on a literature review and consultation with experts, encompassing participants’ demographic information.Such as age, gender, ethnicity, place of residence, education level, marital status, religious beliefs, monthly income, occupation, residence, medical payment method, and disease duration.

Chronic disease self-management scale

Chronic Disease Self-Management Scale [16] was used to measure the cognitive ability, psychological quality, lifestyle, and treatment adherence of the study subjects. The scale contains 4 primary indicators and 40 secondary indicators. All items adopt the Likert5 rating method(1 = no, 5 = always). Higher scores mean higher self-management skills. The Cronbach’s alpha coefficient of the scale was 0.919, with good reliability.

Health literacy scale

The Health Literacy Scale for Patients with Chronic Diseases was used to measure patients’ health literacy levels [17]. The scale consists of 24 entries with 4 dimensions: ability to obtain information, ability to communicate and interact, willingness to improve health, and willingness to provide financial support. All items adopt the Likert5 rating method (1 = almost impossible, 5 = no difficulty et al.). A score of less than 96 indicates a lack of health literacy, while a score of more than 96 indicates adequate health literacy. Higher scores mean higher health literacy. The scale Cronbach’αwas 0.864, good reliability and validity.

Electronic health literacy scale

EHealth Literacy in Chronic Disease Patients [18] was used to determine the patient’s ability to detect the quality of information on the Internet. The eHEALS scale consists of 8 entries, including three dimensions: ability to apply online health information and services (entries 1–5), judgemental ability (entries 6 and 7), and decision-making ability (entry 8). Each entry was scored on a 5-point Likert scale, Higher scores representing better e-health literacy, and a score of more than 32 being qualified. The Cronbach’s alpha of the scale was 0.950, with good reliability.

Health empowerment scale

The Chronic Disease Health Empowerment Scale [19] was used to measure the level of health empowerment of chronic patients. The scale consists of 5 dimensions: belief in responsibility, obtaining support, increasing knowledge, participating in treatment, and reconstructing oneself, with a total of 26 items. Each entry was scored on a 5-point Likert scale (1 = strongly disagree, 5 = strongly agree). Higher scores indicating a higher awareness of health empowerment. The scale Cronbach’αwas 0.927, indicating that the scale has good reliability.

Comprehending the social support scale

Comprehending the Social Support Scale [20] was used to measure individuals’ perceived level of social support from different sources. There are 12 items, including three dimensions of family support (items 3, 4, 8, and 11), friend support (items 6, 7, 9, and 12), and other support (1, 2, 5, and 10). Each item was scored on a seven-point scale from 1 (strongly disagree) to 7 (strongly agree). Higher scores indicating a higher level of social support felt by the individual. The scale is generally categorised into three levels, low support status (12–36 points), intermediate support status (37–60 points) and high support status (61–84 points). The total Cronbach’s alpha coefficient for the scale was 0.899, and the split-half reliability was 0.878.

Data collection and quality control methods

On the basis of obtaining the consent of the relevant community management personnel, the researcher used the staged cluster sampling method to select research subjects who met the criteria for distributing the questionnaire. Following the principle of voluntariness, a unified instruction was used to explain how to fill in the questionnaire and the precautions to be taken, and after filling in the questionnaire, it was uniformly collected by the researcher, and for those who could not fill in the questionnaire, the researcher asked for the answer and then filled it in for them. After collecting the questionnaires, the information collected was carefully reviewed and checked, and statistical software was used for data entry and statistical analysis.

Statistical methods

Self-Management Scale as the exogenous variables to carry out the LPA. Initially, only 1 profile was assumed, and then the number of profiles was gradually increased and the parameters of each model were analysed to select the optimal model against the fitting index. Potential profiles were analysed with 3 types of fit indicators [13, 21] (i) Model fit test. The model fit test indicators are Akaike information criterion (AIC), Bayesian information criterion (BIC) and adjusted BIC (aBIC), the smaller the value, the better the model fit. (ii) The classification index is entropy, which takes the value of 0 ~ 1, and the closer to 1, the higher the accuracy. (iii) Likelihood ratio test indicators include LoMendell-Rubin likelihood ratio (LMR), Bootstrap likelihood ratio test (BLRT), p p