Study of Older Adults' Use of Self-Regulation for COPD Self-Management Informs An Evidence-Based Patient Teaching Plan


  • Cheryl L. Brandt PhD RN ACNS-BC

  • Portions of this manuscript are based on data included in an unpublished doctoral dissertation by the author (Brandt, 2005).



People with chronic obstructive pulmonary disease (COPD) have frequent hospitalizations and emergency department visits, often due to COPD exacerbations which worsen disease status. Recognizing exacerbations is challenging; patients must distinguish between day-to-day COPD symptom variations and exacerbation symptoms. Self-regulation theory (Bandura, 1999) is useful for understanding symptom recognition, interpretation, and response. In this article a qualitative study of self-regulation use by 28 older adults with COPD (Brandt, 2005) is summarized.


Twenty-eight community-dwelling older adults were interviewed. Data were analyzed using the interpretive description method.

Results and Discussion

Informants used self-regulation behaviors in varying degrees. Most attended primarily to their breathing, comparing their usual degree of breathlessness and intensifying their everyday self-management practices if breathlessness worsened.

Clinical Relevance

A theory- and evidence-based COPD teaching plan for use by rehabilitation nurses is presented that includes attention to exacerbation recognition.