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. 2025 Aug:84:151968.
doi: 10.1016/j.apnr.2025.151968. Epub 2025 May 22.

Profiles of long COVID symptoms and self-efficacy for self-management: A cross-sectional survey

Weijiao Zhou  1 , Janet L Larson  2 , Philip T Veliz  3 , Kanchani Kitto  4 , Sheree Smith  4
Affiliations

Profiles of long COVID symptoms and self-efficacy for self-management: A cross-sectional survey

Weijiao Zhou et al. Appl Nurs Res. 2025 Aug.

Abstract

Background: Some patients with COVID-19 experience prolonged symptoms, known as long COVID. Self-management promises to improve symptoms, but little is known about the role of self-efficacy for long COVID symptom management.

Objectives: To identify distinct subgroups of patients experiencing long-term post-COVID symptom burden, and to examine the association between the identified subgroups and self-efficacy for symptom management.

Methods: A cross-sectional survey design with a convenience sampling approach. This study included 491 adults who reported experiencing long COVID symptoms. Symptoms (fatigue, dyspnea, sleep disturbance, anxiety), and self-efficacy for self-management (Self-Efficacy for Managing Chronic Disease (SEMCD) and PROMIS Self-Efficacy) were collected. Latent Profile Analysis (LPA) was used to identify profiles of adults with similar patterns of long COVID symptoms. Multinomial logistic regression was used to examine the association between self-efficacy for self-management and distinct profiles, controlling for socio-demographics and health-related characteristics. Participants' strategies to relieve COVID symptoms were collected via open-ended questions and analyzed using content analysis.

Results: The mean age was 40.6 (SD = 14.1) years of age. We identified four profiles based on the long COVID symptom burden: "low burden," "medium burden with low depression," "medium burden with high depression," and "high burden." Participants with a higher score of SEMCD were less likely to be in Group 3 (medium burden with high depression) (RRR: 0.76, 95 % CI: 0.60-0.96, P = 0.024) and Group 4 (high burden) (RRR: 0.71, 95 % CI: 0.50-1.00, P = 0.049). Participants with a higher score on PROMIS Self-Efficacy were less likely to be in Group 3 (RRR = 0.95, 95 % CI: 0.90-1.00, P = 0.047). Participants used a range of wellness activities and self-medication strategies to self-manage symptoms.

Conclusion: Patients with long COVID had four distinct symptom profiles. Greater self-efficacy was associated with the profiles of less symptom burden. Self-efficacy for self-management could be an important target to consider when developing interventions to improve symptom self-management and reduce long COVID symptom burden.

Keywords: COVID-19; Long COVID; PROMIS; Post-COVID condition; Self-management.

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Conflict of interest statement

Declaration of competing interest The authors declare no conflict of interest. Data availability The data that support the findings of this study are available from the corresponding author upon reasonable request.

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