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Self-management among patients with chronic obstructive pulmonary disease in China and its association with sociodemographic and clinical variables
Jönköping University, School of Health and Welfare, HHJ. ADULT.
Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
School of Nursing, Tianjin Medical University, Tianjin, China.
Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
2016 (English)In: Applied Nursing Research, ISSN 0897-1897, E-ISSN 1532-8201, Vol. 32, p. 61-66Article in journal (Refereed) Published
Abstract [en]

PURPOSE: This study aimed to examine the status of self-management in patients with COPD and its associations with sociodemographic and clinical variables.

METHODS: This cross-sectional study included 154 patients with COPD (mean age, 73 years) at four hospitals in Tianjin, China. The COPD Self-Management Scale was used to describe the level of self-management, and its associations with sociodemographic and clinical variables were examined with multiple regression analysis.

RESULTS: More than half of the patients with COPD had a low (30%) or moderate (27%) level of self-management. Self-management was rated highest in management of daily life and lowest in information management. Higher physical activity, higher salary, and lower age affected self-management the most positively.

CONCLUSION: The overall burden of COPD in China is greater than that found in other countries. Healthcare professionals need to improve their understanding of the importance of self-management and specifically focus on increased physical activity targeting patients with poor literacy skills.

Place, publisher, year, edition, pages
2016. Vol. 32, p. 61-66
Keywords [en]
Self-management; Chronic obstructive pulmonary disease; Sociodemographic variables; Clinical variables
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hj:diva-34600DOI: 10.1016/j.apnr.2016.05.001ISI: 000388057100012PubMedID: 27969053Scopus ID: 2-s2.0-84969786258Local ID: HHJIMPROVEIS, HHJADULTISOAI: oai:DiVA.org:hj-34600DiVA, id: diva2:1061351
Available from: 2017-01-02 Created: 2017-01-02 Last updated: 2018-08-20Bibliographically approved
In thesis
1. A health coaching self-management programme for patients with Chronic Obstructive Pulmonary Disease: An explorative and interventional study
Open this publication in new window or tab >>A health coaching self-management programme for patients with Chronic Obstructive Pulmonary Disease: An explorative and interventional study
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Chronic Obstructive Pulmonary Disease (COPD) is a primary cause of chronic morbidity and mortality and contributes to an increased economic and social burden on patients and families. Self-management education as one non-pharmacological treatment approach is highlighted in guidelines. Although self-management programmes have shown positive effects for COPD, lack of disease-specific self-management skills, high dropout rates, and poor attendance of participants are problems which should be taken under consideration. One way to cope with the problems is to use amore motivational approach which focuses on patients’ health decisions in cooperation with healthcare practitioners, combined with systematic and structured health coaching. However, there is a lack of such studies, which are needed to explore the effects of self-management on patients with COPD by health coaching, not least in China.

Aims: The overall aim of this thesis was to explore sociodemographic and clinical factors influencing self-management and to test and evaluate a health coaching self-management programme for patients with COPD in China.

Methods: The study’s design was explorative, prospective, and longitudinal, with both quantitative and qualitative approaches. Specifically, a quantitative method with a cross-sectional approach was used to explore the self-management status of patients with COPD and examine the associations with socio-demographic and clinical variables (I). Furthermore, a prospective randomized controlled trial was conducted to study the longitudinal effects of the health coaching self-management programme using a repeated-measures analysis of variance model of patients with COPD (II & III). A qualitative study implementing inductive content analysis was used to describe and explore participants’ experiences of the health coaching self-management programme of patients with COPD (IV).

Results: High physical activity, high salary, and low age affected the self-management of patients with COPD most positively (I). The health coaching programme improved lung function, physical activity, quality of life, and self-management skills, as well as psychological status in both the short and long term (II & III). Participants expressed their experiences of the health coaching self-management programme as making them more aware of the importance of knowledge of the disease and their own responsibilities, taking action to maintain a healthy lifestyle, feeling supported by the programme, and being hindered by individual and programme limitations (IV).

Conclusions: This thesis contributes to knowledge about the self-management skills of patients with COPD, which is low in China. A health coaching self-management programme with iterative interactions between patients and healthcare professionals represented a valuable and effective intervention designed to improve health-related outcomes. Moreover, low literacy, poor physical condition, and family and economic burdens should be taken into account in the development of future self-management programmes in China.

Place, publisher, year, edition, pages
Jönköping: Jönköping University, School of Health and Welfare, 2018. p. 80
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 092
Keywords
Chronic Obstructive Pulmonary Disease, Self-management, Health coaching
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-41179 (URN)978-91-85835-91-1 (ISBN)
Public defence
2018-09-13, Forum Humanum, School of Health and Welfare, Jönköping, 13:00 (English)
Opponent
Supervisors
Available from: 2018-08-20 Created: 2018-08-20 Last updated: 2018-08-20Bibliographically approved

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Wang, LanNygårdh, AnnetteMårtensson, Jan

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