Exploring self-management in patients with chronic obstructive pulmonary disease

The purpose of this study was to describe chronic obstructive pulmonary disease (COPD) patients' disease management defined as prescription management (medication adherence), symptom management (COPD knowledge and self-care efficacy) and emotional management. A purposive sampling of 104 COPD patients from southern Taiwan enrolled in a case management program was recruited. After agreeing to participate, patients completed a questionnaire describing their medication adherence, self-care efficacy, and emotional state and provided personal demographic information. Medication adherence ranged from 20% to 30%. Mean COPD knowledge, as tested using a specially developed questionnaire, was 64.4%. Very few subjects (3.8%) expressed confidence in performing self-care behaviors. Only eight patients (7.7%) reported significant depression. Analysis of variance determined that COPD patients who lived alone or in assisted living facilities had less symptom management competency. COPD severity was not found to be a determinant of self-management behavior. The findings of this study challenge the widespread belief that COPD case management program should be determined based on disease severity.