ORIGINAL ARTICLE
Factors associated with self-management behaviors of patients with chronic obstructive pulmonary disease
Xiuyan Lan,
Xinyan Lu,
Bilan Yi,
Xiaohuan Chen,
Shuang Jin,
Corresponding Author
Xiuyan Lan
Department of Pulmonary and Critical Care Medicine, Fujian Provincial Hospital , Fuzhou, China
Fujian Medical University Affiliated Clinical Medical Institute, Fuzhou, China
Correspondence
Xiuyan Lan, Department of Pulmonary and Critical Care Medicine, Fujian Provincial Hospital, Fuzhou, China.
Email: [email protected]
Search for more papers by this authorXinyan Lu
ENT-Head&Neck Surgery, Guiqian International General Hospital, Guiyang, China
Search for more papers by this authorBilan Yi
Department of Pulmonary and Critical Care Medicine, Fujian Provincial Hospital , Fuzhou, China
Fujian Medical University Affiliated Clinical Medical Institute, Fuzhou, China
Search for more papers by this authorXiaohuan Chen
Fujian Medical University Affiliated Clinical Medical Institute, Fuzhou, China
Nursing Department, Fujian Provincial Hospital, Fuzhou, China
Search for more papers by this authorShuang Jin
Fujian Medical University Affiliated Clinical Medical Institute, Fuzhou, China
Nursing Department, Fujian Provincial Hospital, Fuzhou, China
Search for more papers by this authorXiuyan Lan,
Xinyan Lu,
Bilan Yi,
Xiaohuan Chen,
Shuang Jin,
Corresponding Author
Xiuyan Lan
Department of Pulmonary and Critical Care Medicine, Fujian Provincial Hospital , Fuzhou, China
Fujian Medical University Affiliated Clinical Medical Institute, Fuzhou, China
Correspondence
Xiuyan Lan, Department of Pulmonary and Critical Care Medicine, Fujian Provincial Hospital, Fuzhou, China.
Email: [email protected]
Search for more papers by this authorXinyan Lu
ENT-Head&Neck Surgery, Guiqian International General Hospital, Guiyang, China
Search for more papers by this authorBilan Yi
Department of Pulmonary and Critical Care Medicine, Fujian Provincial Hospital , Fuzhou, China
Fujian Medical University Affiliated Clinical Medical Institute, Fuzhou, China
Search for more papers by this authorXiaohuan Chen
Fujian Medical University Affiliated Clinical Medical Institute, Fuzhou, China
Nursing Department, Fujian Provincial Hospital, Fuzhou, China
Search for more papers by this authorShuang Jin
Fujian Medical University Affiliated Clinical Medical Institute, Fuzhou, China
Nursing Department, Fujian Provincial Hospital, Fuzhou, China
Search for more papers by this authorAbstract
Aims
To examine self-management behaviors level and discuss the associated factors among chronic obstructive pulmonary disease (COPD) patients.
Methods
A descriptive study design was used. A convenience sample of 124 COPD patients was recruited from three hospitals in Fuzhou. Self-management Behaviors, Social Support Rating Scale and The Family APGAR Score were used to collect data. Descriptive statistics, one-way analysis of variance (ANOVA), Pearson correlation and multiple linear regression were used for data analysis.
Results
The overall score of self-management behaviors ranged 4–41, with a mean score of 21.26 ± 7.72. Pearson correlation analyses and ANOVA revealed that age, course of disease, education, marital status, family function, subjective support, objective support, and availability of support were positively correlated with overall self-management behaviors (p < .05). Multiple linear regression analyses revealed that subjective support and availability of support significantly predicted self-management behaviors.
Conclusions
The level of self-management behaviors of COPD patients was suboptimal. We suggest that people in the patients’ social network should provide support for them, and help them use available resources to improve the level of self-management behaviors.
CONFLICT OF INTEREST
The authors declare there is no conflict of interest.
REFERENCES
- Ashmore, J. A., Emery, C. F., Hauck, E. R., & Macintyre, N. R. (2005). Marital adjustment among patients with chronic obstructive pulmonary disease who are participating in pulmonary rehabilitation. Heart & Lung: The Journal of Critical Care, 34(4), 270–278. https://doi.org/10.1016/j.hrtlng.2004.12.005
- Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Prentice-Hall.
- Bandura, A. (1997). Self-efficacy: The exercise of control. W. H. Freeman.
- Barlow, J., Wright, C., Sheasby, J., Turner, A., & Hainsworth, J. (2002). Self-management approaches for people with chronic conditions: A review. Patient Education and Counseling, 48(2), 177–187. https://doi.org/10.1016/S0738-3991(02)00032-0
- Barton, C., Effing, T. W., & Cafarella, P. (2015). Social support and social networks in COPD: A scoping review. COPD: Journal of Chronic Obstructive Pulmonary Disease, 12(6), 690–702. https://doi.org/10.3109/15412555.2015.1008691
- Bennich, B. B., Munch, L., Egerod, I., Konradsen, H., Ladelund, S., Knop, F. K., Vilsbøll, T., Røder, M., & Overgaard, D. (2019). Patient assessment of family function, glycemic control and quality of life in adult patients with type 2 diabetes and incipient complications. Canadian Journal of Diabetes, 43(3), 193–200. https://doi.org/10.1016/j.jcjd.2018.09.002
- Bennich, B. B., Munch, L., Overgaard, D., Konradsen, H., Knop, F. K., Røder, M., Vilsbøll, T., & Egerod, I. (2020). Experience of family function, family involvement, and self-management in adult patients with type 2 diabetes: A thematic analysis. Journal of Advanced Nursing, 76(2), 621–631. https://doi.org/10.1111/jan.14256
- Benzo, R. P., Kirsch, J. L., Dulohery, M. M., & Abascal-Bolado, B. (2016). Emotional intelligence: A novel outcome associated with wellbeing and self-management in chronic obstructive pulmonary disease. Annals of the American Thoracic Society, 13(1), 10–16. https://doi.org/10.1513/AnnalsATS.201508-490OC
- Bos-Touwen, I., Schuurmans, M., Monninkhof, E. M., Korpershoek, Y., Spruit-Bentvelzen, L., Ertugrul-van der Graaf, I., de Wit, N., & Trappenburg, J. (2015). Patient and disease characteristics associated with activation for self-management in patients with diabetes, chronic obstructive pulmonary disease, chronic heart failure and chronic renal disease: A cross-sectional survey study. PLoS One, 10(5), e0126400. https://doi.org/10.1371/journal.pone.0126400
- Bustamante, A. V., Vilar-Compte, M., & Ochoa Lagunas, A. (2018). Social support and chronic disease management among older adults of Mexican heritage: A U.S.-Mexico perspective. Social Science & Medicine, 216, 107–113. https://doi.org/10.1016/j.socscimed.2018.09.025
- Cecere, L. M., Slatore, C. G., Uman, J. E., Evans, L. E., Udris, E. M., Bryson, C. L., & Au, D. H. (2012). Adherence to long-acting inhaled therapies among patients with chronic obstructive pulmonary disease (COPD). COPD: Journal of Chronic Obstructive Pulmonary Disease, 9(3), 251–258. https://doi.org/10.3109/15412555.2011.650241
- Chaouat, A., Naeije, R., & Weitzenblum, E. (2008). Pulmonary hypertension in COPD. The European Respiratory Journal, 32(5), 1371–1385. https://doi.org/10.1183/09031936.00015608
- Chau, T. T., Hsiao, T. M., Huang, C. T., & Liu, H. W. (1991). A preliminary study of family Apgar index in the Chinese. The Kaohsiung Journal of Medical Sciences, 7(1), 27–31 (in Chinese).
- Chen, Y. C., Chang, L. C., Liu, C. Y., Ho, Y. F., Weng, S. C., & Tsai, T. I. (2018). The roles of social support and health literacy in self-management among patients with chronic kidney disease. Journal of Nursing Scholarship, 50(3), 265–275. https://doi.org/10.1111/jnu.12377
- Cramm, J. M., & Nieboer, A. P. (2012). Self-management abilities, physical health and depressive symptoms among patients with cardiovascular diseases, chronic obstructive pulmonary disease, and diabetes. Patient Education and Counseling, 87(3), 411–415. https://doi.org/10.1016/j.pec.2011.12.006
- Fang, L., Gao, P., Bao, H., Tang, X., Wang, B., Feng, Y., Cong, S., Juan, J., Fan, J., Lu, K., Wang, N., Hu, Y., & Wang, L. (2018). Chronic obstructive pulmonary disease in China: a nationwide prevalence study. The Lancet Respiratory Medicine, 6(6), 421–430. https://doi.org/10.1016/S2213-2600(18)30103-6
- Gallant, M. P. (2003). The influence of social support on chronic illness self-management: A review and directions for research. Health Education & Behavior, 30(2), 170–195. https://doi.org/10.1177/1090198102251030
- Garcia-Aymerich, J., Serra Pons, I., Mannino, D. M., Maas, A. K., Miller, D. P., & Davis, K. J. (2011). Lung function impairment, COPD hospitalisations and subsequent mortality. Thorax, 66(7), 585–590. https://doi.org/10.1136/thx.2010.152876
- GBD 2016 Causes of Death Collaborators. (2017). Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the global burden of disease study 2016. Lancet, 390(10100), 1151–1210. https://doi.org/10.1016/S0140-6736(17)32152-9
- Glanz, K., & Rimer, B. K. (2005). Theory at a glance: A guide to health promotion practice ( 2nd ed.). National Cancer Institute.
- Global Initiative for Chronic Obstructive Lung Disease. (2016). Global strategy for the diagnosis, management and prevention of COPD. https://goldcopd.org/global-strategy-diagnosis-management-prevention-copd-2016/
- Global Initiative for Chronic Obstructive Lung Disease. (2019). Global strategy for the diagnosis, management and prevention of COPD. https://goldcopd.org/gold-reports/
- Ingebrigtsen, T. S., Marott, J. L., Nordestgaard, B. G., Lange, P., Hallas, J., Dahl, M., & Vestbo, J. (2015). Low use and adherence to maintenance medication in chronic obstructive pulmonary disease in the general population. Journal of General Internal Medicine, 30(1), 51–59. https://doi.org/10.1007/s11606-014-3029-0
- Izquierdo, J. L., Paredero, J. M., & Piedra, R. (2016). Relevance of dosage in adherence to treatment with long-acting anticholinergics in patients with COPD. International Journal of Chronic Obstructive Pulmonary Disease, 11, 289–293. https://doi.org/10.2147/COPD.S96948
- Kaptein, A. A., Fischer, M. J., & Scharloo, M. (2014). Self-management in patients with COPD: theoretical context, content, outcomes, and integration into clinical care. International Journal of Chronic Obstructive Pulmonary Disease, 9, 907–917. https://doi.org/10.2147/COPD.S49622
- Kim, H. F., Kunik, M. E., Molinari, V. A., Hillman, S. L., Lalani, S., Orengo, C. A., Petersen, N. J., Nahas, Z., & Goodnight-White, S. (2000). Functional impairment in COPD patients: The impact of anxiety and depression. Psychosomatics, 41(6), 465–471. https://doi.org/10.1176/appi.psy.41.6.465
- Koetsenruijter, J., van Eikelenboom, N., van Lieshout, J., Vassilev, I., Lionis, C., Portillo, M. C., Foss, C., Serrano Gil, M., Roukova, P., Angelaki, A., Mujika, A., Knutsen, I. R., Rogers, A., & Wensing, M. (2016). Social support and self-management capabilities in diabetes patients: An international observational study. Patient Education and Counseling, 99(4), 638–643. https://doi.org/10.1016/j.pec.2015.10.029
- Korpershoek, Y., Bos-Touwen, I. D., de Man-van Ginkel, J. M., Lammers, J. W., Schuurmans, M. J., & Trappenburg, J. (2016). Determinants of activation for self-management in patients with COPD. International Journal of Chronic Obstructive Pulmonary Disease, 11, 1757–1766. https://doi.org/10.2147/copd.S109016
- Laranjo, L., Neves, A. L., Costa, A., Ribeiro, R. T., Couto, L., & Sá, A. B. (2015). Facilitators, barriers and expectations in the self-management of type 2 diabetes—A qualitative study from Portugal. European Journal of General Practice, 21(2), 103–110. https://doi.org/10.3109/13814788.2014.1000855
- Lenferink, A., Brusse-Keizer, M., van der Valk, P. D., Frith, P. A., Zwerink, M., Monninkhof, E. M., van der Palen, J., & Effing, T. W. (2017). Self-management interventions including action plans for exacerbations versus usual care in patients with chronic obstructive pulmonary disease. The Cochrane Database of Systematic Reviews, 8(8), Cd011682. https://doi.org/10.1002/14651858.CD011682.pub2
- Li, Z. P., Huang, J. Q., & Tang, K. J. (2003). Retrospective studies on 713 cases chronic obstructive pulmonary disease. Chinese Journal of Epidemiology, 24(8), 722–724 (in Chinese).
- Liu, X., Xu, H., & Tang, N. (2009). The influence of protocol family intervention on hemodialysis patient and family support function of self-management behavior. International Journal of Nursing, 28, 1062–1064.
- Lorig, K., Stewart, A., Ritter, P., González, V., Laurent, D., & Lynch, J. (1996). Outcome measures for health education and other health care interventions. Sage Publications, Inc.
10.4135/9781452232966 Google Scholar
- Lorig, K. R., & Holman, H. R. (2003). Self-management education: History, definition, outcomes, and mechanisms. Annals of Behavioral Medicine, 26(1), 1–7. https://doi.org/10.1207/s15324796abm2601_01
- Lu, C., Yuan, L., Lin, W., Zhou, Y., & Pan, S. (2017). Depression and resilience mediates the effect of family function on quality of life of the elderly. Archives of Gerontology and Geriatrics, 71, 34–42. https://doi.org/10.1016/j.archger.2017.02.011
- Luttik, M. L., Jaarsma, T., Moser, D., Sanderman, R., & van Veldhuisen, D. J. (2005). The importance and impact of social support on outcomes in patients with heart failure: an overview of the literature. The Journal of Cardiovascular Nursing, 20(3), 162–169. https://doi.org/10.1097/00005082-200505000-00007
- Ma, W., Kang, D., Song, Y., Wei, C., Marley, G., & Ma, W. (2015). Social support and HIV/STDs infections among a probability-based sample of rural married migrant women in Shandong Province, China. BMC Public Health, 15(1), 1170. https://doi.org/10.1186/s12889-015-2508-5
- Majothi, S., Jolly, K., Heneghan, N. R., Price, M. J., Riley, D., Tuner, A. M., Bayliss, S. E., Moore, D. J., Singh, S. J., Adab, P., Fitzmaurice, D. A., & Jordan, R. E. (2015). Supported self-management for patients with COPD who have recently been discharged from hospital: a systematic review and meta-analysis. International Journal of Chronic Obstructive Pulmonary Disease, 10, 853–867. https://doi.org/10.2147/COPD.S74162
- Maurer, J., Rebbapragada, V., Borson, S., Goldstein, R., Kunik, M. E., Yohannes, A. M., Hanania, N. A., & ACCP Workshop Panel on Anxiety and Depression in COPD (2008). Anxiety and depression in COPD: current understanding, unanswered questions, and research needs. Chest, 134(4 suppl), 43s–56s. https://doi.org/10.1378/chest.08-0342
- Mayberry, L. S., & Osborn, C. Y. (2014). Family involvement is helpful and harmful to patients’ self-care and glycemic control. Patient Education and Counseling, 97(3), 418–425. https://doi.org/10.1016/j.pec.2014.09.011
- Mueller, S., Wilke, T., Bechtel, B., Punekar, Y. S., Mitzner, K., & Virchow, J. C. (2017). Non-persistence and non-adherence to long-acting COPD medication therapy: A retrospective cohort study based on a large German claims dataset. Respiratory Medicine, 122, 1–11. https://doi.org/10.1016/j.rmed.2016.11.008
- Niti, M., Ng, T. P., Kua, E. H., Ho, R. C., & Tan, C. H. (2007). Depression and chronic medical illnesses in Asian older adults: The role of subjective health and functional status. International Journal of Geriatric Psychiatry, 22(11), 1087–1094. https://doi.org/10.1002/gps.1789
- Ngo, C. Q., Phan, D. M., Vu, G. V., Dao, P. N., Phan, P. T., Chu, H. T., Nguyen, L. H., Vu, G. T., Ha, G. H., Tran, T. H., Tran, B. X., Latkin, C. A., Ho, C. S. H., & Ho, R. C. M. (2019). Inhaler technique and adherence to inhaled medications among patients with acute exacerbation of chronic obstructive pulmonary disease in Vietnam. International Journal of Environmental Research and Public Health, 16(2), 185–192. https://doi.org/10.3390/ijerph16020185
- Ngo, C. Q., Thi Bui, T., Vu, G. V., Chu, H. T., Phan, P. T., Ngoc Pham, H., Vu, G. T., Nguyen, L. H., Ha, G. H., Tran, B. X., Latkin, C. A., Ho, C. S. H., & Ho, R. C. M. (2018). Direct hospitalization cost of patients with acute exacerbation of chronic obstructive pulmonary disease in Vietnam. International Journal of Environmental Research and Public Health, 16(1), 88–95. https://doi.org/10.3390/ijerph16010088
- Quint, J. (2017). The relationship between COPD and cardiovascular disease. Tanaffos, 16(suppl 1), S16–s17.
- Restrepo, M. I., Sibila, O., & Anzueto, A. (2018). Pneumonia in patients with chronic obstructive pulmonary disease. Tuberculosis and Respiratory Diseases (Seoul), 81(3), 187–197. https://doi.org/10.4046/trd.2018.0030
- Rosland, A. M., Heisler, M., Choi, H.-J., Silveira, M. J., & Piette, J. D. (2010). Family influences on self-management among functionally independent adults with diabetes or heart failure: do family members hinder as much as they help? Chronic Illness, 6(1), 22–33. https://doi.org/10.1177/1742395309354608
- Schulman-Green, D., Jaser, S. S., Park, C., & Whittemore, R. (2016). A metasynthesis of factors affecting self-management of chronic illness. Journal of Advanced Nursing, 72(7), 1469–1489. https://doi.org/10.1111/jan.12902
- Smilkstein, G. (1978). The family APGAR: A proposal for family function test and its use by physicians. The Journal of Family Practice, 6(6), 1231–1239.
- Spruit, M. A., Vercoulen, J. H., Sprangers, M. A. G., & Wouters, E. F. M. (2017). Fatigue in COPD: An important yet ignored symptom. The Lancet Respiratory Medicine, 5(7), 542–544. https://doi.org/10.1016/s2213-2600(17)30158-3
- Tian, J. L., He, Y. L., Liu, Y., Gongye, H. J., & Zhang, S. (2017). The research on self-management behavior among rural elderly patients with chronic diseases. Chinese Nursing Management, 17(5), 619–624 (in Chinese).
- Thoits, P. A. (1995). Stress, coping, and social support processes: Where are we? What next? Journal of Health and Social Behavior, 35, 53–79.
- Vestbo, J., Anderson, J. A., Calverley, P. M. A., Celli, B., Ferguson, G. T., Jenkins, C., Knobil, K., Willits, L. R., Yates, J. C., & Jones, P. W. (2009). Adherence to inhaled therapy, mortality and hospital admission in COPD. Thorax, 64(11), 939–943. https://doi.org/10.1136/thx.2009.113662
- Vu, G. V., Ha, G. H., Nguyen, C. T., Vu, G. T., Pham, H. Q., Latkin, C. A., Tran, B. X., Ho, R. C. M., & Ho, C. S. H. (2020). Interventions to improve the quality of life of patients with chronic obstructive pulmonary disease: A global mapping during 1990-2018. International Journal of Environmental Research and Public Health, 17(9), 3089–3102. https://doi.org/10.3390/ijerph17093089
- Wang, L., Nygårdh, A., Zhao, Y., & Mårtensson, J. (2016). Self-management among patients with chronic obstructive pulmonary disease in China and its association with sociodemographic and clinical variables. Applied Nursing Research, 32, 61–66. https://doi.org/10.1016/j.apnr.2016.05.001
- Warwick, M., Gallagher, R., Chenoweth, L., & Stein-Parbury, J. (2010). Self-management and symptom monitoring among older adults with chronic obstructive pulmonary disease. Journal of Advanced Nursing, 66(4), 784–793. https://doi.org/10.1111/j.1365-2648.2009.05238.x
- Xiao, S. Y. (1994). The theoretical basis and application of social support questionnaire. Journal of Clinical Psychology in Medical Settings, 4, 98–100.
- Xie, H., Peng, W., Yang, Y., Zhang, D., Sun, Y., Wu, M., Zhang, J., Jia, J., & Su, Y. (2017). Social support as a mediator of physical disability and depressive symptoms in Chinese elderly. Archives of Psychiatric Nursing, 32(2), 256–262. https://doi.org/10.1016/j.apnu.2017.11.012
- Yan, L. H., Leng, B. Z., & Xu, B. (2009). The cognition and requirement for health education of COPD. Chinese Primary Health Care, 23(2), 62–63 (in Chinese).
- Yang, H., Wang, H., Du, L., Wang, Y., Wang, X., & Zhang, R. (2019). Disease knowledge and self-management behavior of COPD patients in China. Medicine, 98(8), e14460. https://doi.org/10.1097/md.0000000000014460
- Zhang, M. W., Ho, R. C., Cheung, M. W., Fu, E., & Mak, A. (2011). Prevalence of depressive symptoms in patients with chronic obstructive pulmonary disease: A systematic review, meta-analysis and meta-regression. General Hospital Psychiatry, 33(3), 217–223. https://doi.org/10.1016/j.genhosppsych.2011.03.009
- Zwerink, M., Brusse-Keizer, M., van der Valk, P. D., Zielhuis, G. A., Monninkhof, E. M., van der Palen, J., Frith, P. A, & Effing, T. (2014). Self management for patients with chronic obstructive pulmonary disease. The Cochrane Database of Systematic Reviews, 2014(3), Cd002990. https://doi.org/10.1002/14651858.CD002990.pub3
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