Exploring self-management in patients with chronic obstructive pulmonary disease

: The purpose of this study was to describe chronic obstructive pulmonary disease (COPD) patients' disease management defined as prescription management (medication adherence), symptom management (COPD knowledge and self-care efficacy) and emotional management. A purposive sampling of 104 COPD patients from southern Taiwan enrolled in a case management program was recruited. After agreeing to participate, patients completed a questionnaire describing their medication adherence, self-care efficacy, and emotional state and provided personal demographic information. Medication adherence ranged from 20% to 30%. Mean COPD knowledge, as tested using a specially developed questionnaire, was 64.4%. Very few subjects (3.8%) expressed confidence in performing self-care behaviors. Only eight patients (7.7%) reported significant depression. Analysis of variance determined that COPD patients who lived alone or in assisted living facilities had less symptom management competency. COPD severity was not found to be a determinant of self-management behavior. The findings of this study challenge the widespread belief that COPD case management program should be determined based on disease severity.