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Effects of a self-management education program on self-efficacy in patients with COPD: a mixed-methods sequential explanatory designed study

Authors Ng WI, Smith GD

Received 5 March 2017

Accepted for publication 30 May 2017

Published 20 July 2017 Volume 2017:12 Pages 2129—2139

DOI https://doi.org/10.2147/COPD.S136216

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Charles Downs

Peer reviewer comments 3

Editor who approved publication: Dr Richard Russell

Wai I Ng,1 Graeme Drummond Smith2

1Education Department, Kiang Wu Nursing College of Macau, Macau SAR, People’s Republic of China; 2Education Department, School of Health & Social Care, Edinburgh Napier University, Edinburgh, Midlothian, UK

Background: Self-management education programs (SMEPs) are potentially effective in the symptomatic management of COPD. Little is presently known about the effectiveness of these programs in Chinese COPD patients. The objective of this study was to evaluate the effectiveness of a specifically designed SMEP on levels of self-efficacy in Chinese patients with COPD.
Materials and methods: Based on the Medical Research Council framework for evaluating complex interventions, an exploratory phase randomized controlled trial was employed to examine the effects of an SMEP. Self-efficacy was the primary outcome using the COPD Self-efficacy Scale, measured at baseline and 6 months after the program. Qualitative data were sequentially collected from these patients via three focus groups to supplement the quantitative findings.
Results: The experimental group displayed significant improvement in their general self-efficacy (Z =-2.44, P=0.015) and specifically in confronting 1) physical exertion (Z =-2.57, P=0.01), 2) weather/environment effects (Z =-2.63, P<0.001) and 3) intense emotions (Z =-2.54, P=0.01). Three themes emerged from the focus groups: greater disease control, improved psychosocial well-being and perceived incapability and individuality. The connection of the quantitative and qualitative data demonstrated that individual perceptual constancy of patients could be a determining factor modulating the effectiveness of this type of intervention.
Conclusion: These findings highlight the potential putative benefits of an SMEP in Chinese patients with COPD. Further attention should be given to cultural considerations when developing this type of intervention in Chinese populations with COPD and other chronic diseases.

Keywords: COPD, embedded design, exploratory randomized controlled trial, mixed methods, self-efficacy, self-management

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