Department of Public Health & General Practice, University of Otago, Christchurch, New Zealand.
Chron Respir Dis. 2010;7(2):83-90. doi: 10.1177/1479972310365363. Epub 2010 Mar 18.
The rationale for introducing self-management plans for the whole chronic obstructive pulmonary disease (COPD) population is uncertain. This study's aim was to investigate whether people with panic disorder (PD), compared to non-panic-disordered (NPD), derived additional educational or psychological benefits from having a self-management plan. The 24-week prospective study followed 76 participants hospitalized with an exacerbation of COPD. Participants completed mental health questionnaires including psychological measures of self-management plan impact. Subsequently, a nurse provided education for using a self-management plan. All participants were Plan naïve irrespective of their PD status. Self-management knowledge was assessed before introducing the Plan (baseline), 1 week post discharge and at 24 weeks. At baseline 28 (37%) of participants met the criteria for PD and this group had higher scores (better knowledge) for an impending (p < 0.05) and severe exacerbation (p < 0.05) and capacity to act during a severe exacerbation (p < 0.01). No interaction effect was found between PD and NPD scores over time, indicating that the PD's knowledge did not improve or deteriorate over time relative to the NPD. Evidence was mixed regarding the Plan's psychological impact. Self-management confidence improved in both groups. Amongst the PD group, perceived control of self-management tasks increased but so did body vigilance and distress about having COPD. There is mixed evidence regarding educational and psychological benefits of COPD self-management plans for people with PD. No additional educational advantages were found for the PD group. Plans may increase confidence and control over self-management but may also increase body vigilance and distress about having COPD.
引入整体慢性阻塞性肺疾病（COPD）人群自我管理计划的基本原理尚不确定。本研究旨在调查与非惊恐障碍（NPD）相比，惊恐障碍（PD）患者是否从自我管理计划中获得了额外的教育或心理益处。这项为期 24 周的前瞻性研究纳入了 76 名因 COPD 加重而住院的患者。参与者完成了心理健康问卷，包括自我管理计划影响的心理测量。随后，护士提供了使用自我管理计划的教育。所有参与者均为计划新手，无论其 PD 状态如何。在引入计划之前（基线）、出院后 1 周和 24 周评估自我管理知识。在基线时，28 名（37%）参与者符合 PD 标准，且该组在即将发生（p < 0.05）和严重加重（p < 0.05）以及在严重加重期间采取行动的能力方面得分更高（更好的知识）（p < 0.01）。PD 和 NPD 分数之间未发现时间上的交互作用，表明与 NPD 相比，PD 的知识没有随时间改善或恶化。计划的心理影响证据不一。两组的自我管理信心均有所提高。在 PD 组中，自我管理任务的感知控制增加了，但对 COPD 的身体警觉和困扰也增加了。PD 患者 COPD 自我管理计划在教育和心理方面的益处证据不一。PD 组没有发现额外的教育优势。计划可能会提高自我管理的信心和控制感，但也可能会增加对 COPD 的身体警觉和困扰。
