Factors Affecting Self-Management Behaviors of Patients with Chronic Obstructive Pulmonary Disease: A Literature Review

Saturday, 26 July 2014

Ching Ching Li, MPH, BSN, RN1
Diana T. F. Lee, PhD, MSc, PRD (HCE), RM, RN, RTN1
Doris Y. P. Leung, BSc, MPhil, PhD2
(1)The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, Hong Kong
(2)The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong SAR, China

Purpose:To review factors affecting self-management behaviors of patients with chronic obstructive pulmonary disease (COPD).

Methods:Ten electronic databases AMED, BNI, CINAHL, EMBASE, MEDLINE, PsycINFO, Cochrane Database of Systematic Review, China Journal Net, Taiwan Electronic Periodical Services and Google Scholar were searched using keywords, including “chronic obstructive pulmonary disease” ; “chronic obstructive airway disease”; “self-management” and “self-care” from inception to March 2013. Original research exploring factors affecting self-management behaviors in COPD patients published English or Chinese with full-text were selected. Studies which recruited subjects with asthma or major psychiatric illnesses were excluded.

Results: Twenty-one studies were included in the final review. Seven of them were cross-sectional studies and 14 were qualitative studies. Fourteen factors relating to self-management behaviors in COPD patients were identified and categorized into four domains: 1) cognitive; 2) physical; 3) psychological; and 4) social. Cognitive domain contains one factor which is knowledge. Physical domain includes three factors of dyspnea, fatigue and physical limitation. Psychological domain covers five factors and they are self-efficacy, perceived usefulness, sense of coherence, perceived helplessness and depression. Social domain encompasses three factors which are social support from family, peer and healthcare providers.

Conclusion: Upon reviewing the literature, a total number of 14 factors were identified. However, factors found from empirical studies were discrete and isolated reflecting a lack of a comprehensive picture of factors affecting self-management behaviors in COPD patients. Therefore, future study could consider developing a comprehensive evidence-based COPD self-management model for guiding future interventions in promoting self-management behaviors in COPD patients.