Paper
Wednesday, 19 July 2006
This presentation is part of : Strategies for Care of the Chronically Ill
Older Adults' Descriptions of Their Use of Self-Regulation for Chronic Obstructive Pulmonary Disease (COPD) Self-Management
Cheryl L. Brandt, PhD, APRN, BC, Adult Health Nursing Department, College of Nursing and Health Sciences, University of Wisconsin-Eau Claire, Eau Claire, WI, USA
Learning Objective #1: Describe the construct of self-regulation as developed in Social Cognitive Theory.
Learning Objective #2: Discuss the self-regulation behaviors reported as used in self-management by a convenience sample of older adults with chronic obstructive pulmonary disease (COPD).
             Chronic disease care requires self-management involving on-going complex decision making. Self-regulation is posited to be core to that decision making. The purposes of the qualitative arm of a descriptive, cross-sectional, mixed-methods study were to describe the largely unexplored process of self-regulation in older adults with Chronic Obstructive Pulmonary Disease (COPD) and to contribute to development of a Social Cognitive Theory-based Collaborative Model for Self-Management of Chronic Disease. Bandura’s conceptualization of self-regulation as a tripartite process (self-observation, self-judgment, and self-reaction) served as the theoretical basis for the qualitative research.
           A convenience sample of 28 adults (19 males/9 females) with COPD (mean age 69.1 years, S.D. 6.7) were interviewed for their descriptions of self-regulation and COPD self-management. Interviews were transcribed verbatim and analyzed using the Interpretive Description method.              Informants’ reported self-regulation behaviors included self-observations of dyspnea, activity tolerance, and other symptoms. Their self-judgments focused on degree of symptom change from baseline. They described behavioral self-reactions to reduce symptoms to baseline. Subjects used self-regulation to monitor their disease status and influence management decisions. Future research should include developing a self-regulation measure specific to people with COPD, testing the Collaborative Model for conceptual completeness, and investigating the effectiveness of a self-management program that is based on the model and that includes interventions to promote self-regulation.

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