Symptom burden and self-management in persons with chronic obstructive pulmonary disease

Abstract

Heidi B Bringsvor,1,2 Knut Skaug,1 Eva Langeland,3 Bjørg Frøysland Oftedal,2 Jörg Assmus,4 Doris Gundersen,1 Richard H Osborne,5 Signe Berit Bentsen2 1Department of Research and Innovation, Helse Fonna HF, Haugesund, 2Department of Quality and Health Technology, University of Stavanger, Stavanger, 3Department of Nursing, Western Norway University of Applied Sciences, 4Center for Clinical Research, Haukeland University Hospital, Bergen, Norway; 5Health Systems Improvement Unit, School of Health and Social Development, Centre For Population Health Research, Deakin University, Burwood, Victoria, Australia Purpose: Self-management is crucial for effective COPD management. This study aimed at identifying associations between self-management and sociodemographic characteristics, clinical characteristics, and symptom burden in people with COPD. Patients and methods: In this cross-sectional study with 225 participants diagnosed with COPD grades II–IV, multiple linear regression analysis was conducted, using sociodemographic and clinical characteristics and symptom burden (COPD Assessment Test) as the independent variables and the eight self-management domains of the Health Education Impact Questionnaire (heiQ) as the outcome variables. Results: Higher symptom burden was significantly associated with worse scores in all self-management domains (p<0.003), except for self-monitoring and insight (p=0.012). Higher disease severity (p=0.004) and numbers of comorbidities (p<0.001) were associated with more emotional distress, and women scored higher than men on positive and active engagement in life (p=0.001). Higher score in pack-years smoking was associated with lower score in health-directed activities (p=0.006) and self-monitoring and insight (p<0.001), and participation in organized physical training was associated with higher score in health-directed activities (p<0.001). The final models explained 3.7%–31.7% of variance (adjusted R2) across the eight heiQ scales. Conclusion: A notable finding of this study was that higher symptom burden was associated with worse scores in all self-management domains, except for self-monitoring and insight. In addition, sex, disease severity, comorbidity, pack-years smoking, and participation in organized physical training were associated with one or two self-management domains. The study contributes to improved understanding of self-management in COPD. However, the explained variance levels indicate that more research needs to be done to uncover what else explains self-management domains in COPD. Keywords: COPD, Health Education Impact Questionnaire, COPD Assessment Test, self-management, symptoms, chronic disease

Keywords

• COPD
• Health Education Impact Questionnaire
• COPD Assessment Test
• self-management
• symptoms