Self-management and symptom monitoring among older adults with chronic obstructive pulmonary disease

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Journal Article
Journal of Advanced Nursing, 2010, 66 (4), pp. 784 - 793
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Aims: To describe self-management, symptom monitoring and the associated influences among older adults with chronic obstructive pulmonary disease. Background: Optimal self-management and monitoring of key symptoms in patients with chronic obstructive pulmonary disease reduces dyspnoea and preventable hospitalizations. Method: A prospective, descriptive survey design was used and data collected from patients with moderate severity chronic obstructive pulmonary disease during home interviews between April 2005 and June 2006. Predictors of self-management and symptom monitoring were determined by linear regression analyses. Results: Patients' (n = 78) mean age was 73·37 years (sd 7·52); 55·1% were male and 66·7% were married. Most (92·3%) had concurrent illnesses, and 48·7% had been admitted to hospital for chronic obstructive pulmonary disease in the past 6 months. Self-management was good to very good, with poorer self-management predicted by lower self-efficacy (β = -0·21), a weaker sense of coherence (β = -0·03), and no hospitalization in the past 6 months (β = -05). Symptom monitoring was not ideal, with more than 20% of patients not monitoring any of the key symptoms. More frequent symptom monitoring occurred among participants who were married (β = 5.14) and had more severe disease (β = 0·79). Conclusion: As self-management and symptom monitoring ensure better outcomes among patients with chronic obstructive pulmonary disease, health professionals should encourage these behaviours. Involving partners, promoting self-efficacy and understanding of sense of coherence are helpful in this process. © 2010 Blackwell Publishing Ltd.
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