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Keywords:

  • chronic illness;
  • chronic obstructive pulmonary disease;
  • nursing;
  • self-efficacy;
  • self-management;
  • sense of coherence;
  • symptom monitoring

warwick m., gallagher r., chenoweth l. & stein-parbury j. (2010) Self-management and symptom monitoring among older adults with chronic obstructive pulmonary disease. Journal of Advanced Nursing66(4), 784–793.

Abstract

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

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.