Effects of Self-Management Education Programme in Improving Self-Efficacy of Patients with Chronic Obstructive Pulmonary Disease: An Exploratory Trial

Ng, Wai I

Purpose: Chronic obstructive pulmonary disease (COPD) cannot be cured, but can be prevented and treated. Statistics show that it contributes more to the global burden of disease in terms of disability-adjusted life years (DALYs) than other respiratory diseases. In Macau, respiratory disease is the top three causes of all deaths in recent years (DSEC, 2008), however, the emphasis of healthcare service provision in relation to COPD patients is mainly focused on acute management. Therefore, the purpose of this study is to compare the self-efficacy of Macau COPD patients before and after implementation of self-management education programme (SMEP).

Methods: An exploratory randomized controlled trial (RCT) was adopted (MRC 2008), and a mixed methods approach was employed. 51 consented Macau COPD patients were randomly allocated to experimental and control group. Experimental group received SMEP while the control group received usual conventional care. All patients were assessed with COPD self-efficacy scale before and 6 months after completion of self-management education. Focus group interviews were implemented to explore the subjective view of patients towards their self-efficacy after the education.

Results: The patients demonstrated improvement in general self-efficacy and self-efficacy in intense emotional arousal, physical exertion and weather/environmental effects. The subjective perception of the patients towards the effects of SMEP in improving their self-efficacy was mostly consistent with the quantitative findings, except that the programme was not the main cause for improving their self-efficacy in negative emotional.

Conclusion: Macau COPD patients who are Chinese tend to tolerate intense emotional arousal and this is a significant characteristic in Chinese. Due to the long lacking of chronic patient support, the Macau COPD patients perceive self-management education programme as an essential element of self-efficacy empowerment. Therefore, SMEP is necessary for COPD patients, but most importantly, the design of the education should carefully put cultural factors into consideration.