• acute exacerbation;
  • chronic obstructive pulmonary disease;
  • nursing;
  • randomised controlled trial;
  • self-regulation

Aims and objectives

This study presents a discussion of the physiological and psychological efficacy of a self-regulation protocol in lowering acute exacerbation symptoms in patients with chronic obstructive pulmonary disease.


Patients with chronic obstructive pulmonary disease are often troubled by acute exacerbation and must learn how to prevent this.


A two-group, pretest–post-test experimental design was used in this study.


Data were collected between January–July 2008. Sixty-four participants were randomly assigned either to an intervention (n = 33) or to a comparison (n = 31) group. Both groups were assessed on four separate occasions, namely pretest, post-test 1 (5th week), post-test 2 (9th week) and post-test 3 (13th week). The intervention group received a four-week self-regulation protocol. The comparison group received the self-regulation guidebook only. The Borg Dyspnea Scale, the Symptom Distress Scale, the Pulmonary Functional Status Scale, the chronic obstructive pulmonary disease Self-Efficacy Scale and the peak expiratory flow were used to measure differences between pretest and post-test values.


On the 5th, 9th and 13th weeks after the self-regulation protocol intervention, we found significantly better scores in the four scales in the intervention group compared to those in the comparison group. On the 9th and 13th weeks, there was a significantly greater peak expiratory flow in the intervention group. The intervention group also showed a lower rate of unscheduled physician visits because of acute exacerbation than the comparison group.


The findings indicate that the self-regulation protocol developed in this study could significantly assist participants to control their individual symptoms and avoid acute exacerbation.

Relevance to clinical practice

Healthcare professionals could apply the protocol developed in this study to assist patients to learn the strategies of self-regulation to prevent their acute exacerbation symptoms.