Patient Preference and Adherence (Jul 2023)
Demographic, Physical, and Psychological Determinants of Patient Experience with Subcutaneous Self-Injection in Patients with Rheumatoid Arthritis: Structural Equation Modeling Approach
Abstract
Akira Onishi,1,2 Maiko Kaizu,3 Iku Shirasugi,2 Tomoko Yagyu,3 Yo Ueda,2 Yoshitada Sakai,4 Yasushi Miura,5 Jun Saegusa2 1Department of Advanced Medicine for Rheumatic Diseases, Kyoto University Graduate School of Medicine, Kyoto, Japan; 2Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, Kobe, Japan; 3Department of Nursing, Kobe University Hospital, Kobe, Japan; 4Division of Rehabilitation Medicine, Kobe University Graduate School of Medicine, Kobe, Japan; 5Department of Rehabilitation Sciences, Kobe University Graduate School of Health Sciences, Kobe, JapanCorrespondence: Akira Onishi, Department of Advanced Medicine for Rheumatic Diseases, Kyoto University Graduate School of Medicine, 54 ShogoinKawahara-chou Sakyo-ku, Kyoto-shi, Kyoto, 606-8507, Japan, Tel +8175-751-3877, Fax +8175-751-3885, Email [email protected]: To achieve a better patient experience with self-injection, an assessment of potential demographic, physical, and psychological barriers is necessary. The aim of this study was to examine the demographic, physical, and psychological characteristics associated with the experiences of self-injection in patients with rheumatoid arthritis (RA).Patients and Methods: In this study, overall patient experience with subcutaneous self-injection was assessed using the Self-Injection Assessment Questionnaire. Upper limb function was assessed using the three domains of the Health Assessment Questionnaire associated with upper extremity disability (dressing and grooming, eating, and grip). Structural equation modeling was used to estimate the association between the demographic and clinical characteristics of patients with RA and their experiences with self-injection in the theoretical model.Results: Data from 83 patients with RA were analyzed. Compared with younger patients, elderly patients were more likely to experience lower self-confidence, self-image, and ease of use. Female patients had lower ease of use than male patients. In terms of upper limb function, patients with more difficulty in performing activities of daily living were more likely to have a lower self-image. Self-injection perceptions before learning the method of injection, such as fear of needles and anxiety about self-injection, were associated with post-injection feelings, injection site reactions, self-confidence, and ease of use.Conclusion: To optimize patients’ experiences with self-injection, healthcare workers should assess each patient’s age, sex, upper limb function, and pre-self-injection perceptions as demographic, physical, and psychological barriers.Keywords: rheumatoid arthritis, self-injection, biologics, self-injection assessment questionnaire
