From Cues to Action: Information Seeking and Exercise Self-Care among Older Adults Managing Chronic Illness

Résumé

À partir du modèle de croyance à la santé, des pistes d'action visant à influencer les comportements en matière de santé ont été élaborées; cependant, peu d'études ont abordé ces concepts de façon explicite. La présente étude examine la relation entre l'autogestion de la santé et les informations pouvant pousser une personne à prendre des mesures. Nous avons émis l'hypothèse que les lectures comportant des renseignements sur les maladies, la connaissance des services, ainsi que la consultation d'autres personnes au sujet de sa propre maladie stimulaient une gestion autonome de la santé. L'échantillon, tiré du Vancouver North Shore Self-Care Study, était constitué de 879 adultes atteints de maladies chroniques et âgés de 50 ans et plus. Nous avons découvert que la probabilité de prendre des mesures d'autogestion de la santé était presque deux fois plus élevée chez les gens qui lisaient des informations sur la maladie (par comparaison avec ceux qui n'en lisaient pas), après avoir effectué des vérifications relatives aux facteurs sociodémographiques, au contexte de la maladie et à l'activité intrinsèque de la maladie. Par ailleurs, la connaissance des services et les consultations semblaient accroître la probabilité que l'on prenne des mesures d'autogestion de la santé. Ces résultats semblent démontrer l'importance des informations pouvant pousser les gens à prendre des mesures à titre de concept théorique fondamental. Les conséquences potentielles de ces résultats sur les programmes de promotion qui ciblent les personnes atteintes de maladies chroniques sont abordées.

Abstract

Drawing from the health belief model, cues to action have been theorized to influence health behaviours; however, few studies have examined these constructs explicitly. This study investigated the relationship between information cues to action and exercise self-care. It was hypothesized that reading about illness information, knowing about services, and consulting with others about one's illness triggers exercise self-care. The sample consisted of 879 chronically ill adults aged 50 and over, drawn from the Vancouver North Shore Self-Care Study. It was found that the odds of exercising almost doubled for readers of information about illness (compared to non-readers), after controlling for socio-demographic factors, illness context, and illness efficacy. Furthermore, knowledge of services and consultations were shown to increase the odds of exercise self-care. These findings provide support for the salience of cues to action as a pivotal theoretical construct. The implications of these findings for health promotion programs targeting persons with chronic illnesses are discussed.

Introduction

A key aspect of health promotion is enabling individuals to control, maintain, and improve their health by making informed decisions (Terris, 1992). As people age and often experience chronic illness, an important aspect of health behaviour is termed self-care (McDonald-Miszczak, Wister, & Gutman, 2001; Morrongiello & Gottlieb, 2000; Ory & DeFriese, 1998). Self-care has been defined as a continuum of caring for the self to enhance health, prevent disease, evaluate symptoms, and restore health, which is organized by perceptions, decisions, and the options available to each individual (Dean & Kickbusch, 1995). It therefore encompasses a constellation of preventive health behaviours and responses to illness that influence health, wellness, and illness management and can be particularly beneficial in later life (Morrongiello & Gottlieb, 2000; Wister, 2003). The World Health Organization (1983) added to this definition of self-care the notion that these activities are derived from knowledge and skills originating from both professional and lay experience. This suggests that self-care behaviour needs to be understood as the consequence of information seeking, awareness of options, health knowledge, professional consultation, and the motivational impetus embedded in these key processes.

As one central type of self-care, exercise has been found to have a positive impact on older adults' physical and mental well...