The Effect Of Self-management Programme On The Knowledge, Beliefs And Behavior Of Patients With COPD

Objective:To study the effect of self-management programme on the knowledge, beliefs, and behavioral outcomes of patients with stable Chronic Obstructive Pulmonary Disease (COPD).Method:Sixty-eight patients with COPD were randomly divided into two groups. The patients in the intervention group received the intervention of self-management programme in their families while the control group was only given the conventional education. Self-management programme included8weeks of education (the first6weeks was devoted to the imparting of knowledge about COPD, and the next2weeks was spent on the training of rehabilitative behaviors) by professional nurses with one-to-one individualized interventions at participants’home. Each intervention took about1-2hours. The control group of patients was delivered routine education about COPD during discharge stage by professional nurses. Before and after the self-management programme, we examined the knowledge, attitude and practice (KAP) of COPD patients by COPD Knowledge Questionnaire, Chinese Self-efficacy Scale, COPD Symptom-Management Behavior Confidence Questionnaire, St George’s Respiratory Questionnaire and Dyspnea Scale. The SPSS16.0software was used for statistical analysis.Results:Two months after the intervention, significant differences were found in the total health knowledge score (t=-11.659, P=0.000), the self-efficacy score (t=-9.509, P=0.000) and its dimensions including symptom management (t=-9.528, P=0.000), emotion(t=-9.528, t=0.000), physical exercise (t=-7.043, P=0.000), environment and temperature (t=-9.259, t=0.000) and safety (t=-7.127, P=0.000). Two months after the intervention, significant differences were observed in the intervention group regarding the confidence of breathing exercises (Z=-4.852, P=0.000), physical exercise (Z=-3.947, P=0.000), medication inhalation (Z=-4.852, P=0.000) and home oxygen therapy (Z=-3.145, P=0.002). The average time for oxygen therapy was significantly prolonged (t=0.749, P=0.000); but no statistically significant difference was found in the control group (P>0.05). Two months after the intervention, the total scores of SGRQ (t=4.740, P=0.000), the symptoms (t=3.236, P=0.000), the activity (t=2.374, P=0.000) and the impacts (t=4.445, P=0.000)were significantly reduced for the intervention group. Besides, the scores of breath symptom such as MRC scores (z=-2.236, P=0.025) between the two groups also followed the same pattern while no statistically significant difference was found in the Broge score (t=0.754, P>0.05) of both groups (P>0.05).Conclusion:1. The level of the health knowledge for COPD patients was low; the self-efficacy was at a low-to-middle level; the compliance of the symptom-management behavior was poor.2. Self-management programme could improve the level of the health knowledge of COPD patients, enhance the confidence in symptom-management, and improve the compliance of the symptom-management behavior.3. Self-management programme might bring the improvement of the respiratory symptoms and healths-related quality of life.