National Institute of Health Research CLAHRC-LNR Pulmonary Rehabilitation Research Group, University Hospitals of Leicester NHS, Leicester, UK.
Int J Chron Obstruct Pulmon Dis. 2013;8:317-27. doi: 10.2147/COPD.S40414. Epub 2013 Jul 9.
There is no independent standardized self-management approach available for chronic obstructive pulmonary disease (COPD). The aim of this project was to develop and test a novel self-management manual for individuals with COPD.
Participants with a confirmed diagnosis of COPD were recruited from primary care.
A novel self-management manual was developed with health care professionals and patients. Five focus groups were conducted with individuals with COPD (N = 24) during development to confirm and enhance the content of the prototype manual. The Self-management Programme of Activity, Coping and Education for Chronic Obstructive Pulmonary Disease (SPACE for COPD) manual was developed as the focus of a comprehensive self-management approach facilitated by health care professionals. Preference for delivery was initial face-to-face consultation with telephone follow-up. The SPACE for COPD manual was piloted with 37 participants in primary care. Outcome measures included the Self-Report Chronic Respiratory Questionnaire, Incremental Shuttle Walk Test, and Endurance Shuttle Walking Test (ESWT); measurements were taken at baseline and 6 weeks.
The pilot study observed statistically significant improvements for the dyspnea domain of the Self-Report Chronic Respiratory Questionnaire and ESWT. Dyspnea showed a mean change of 0.67 (95% confidence interval 0.23-1.11, P = 0.005). ESWT score increased by 302.25 seconds (95% confidence interval 161.47-443.03, P < 0.001).
This article describes the development and delivery of a novel self-management approach for COPD. The program, incorporating the SPACE for COPD manual, appears to provoke important changes in exercise capacity and breathlessness for individuals with COPD managed in primary care.
目前尚无针对慢性阻塞性肺疾病（COPD）的独立标准化自我管理方法。本项目旨在开发和测试一种针对 COPD 患者的新型自我管理手册。
从初级保健中招募了确诊为 COPD 的参与者。
与医疗保健专业人员和患者一起开发了一种新型的自我管理手册。在开发过程中，对 24 名 COPD 患者进行了 5 次焦点小组讨论，以确认和增强原型手册的内容。《慢性阻塞性肺疾病活动、应对和教育自我管理计划》（SPACE for COPD）手册作为一种由医疗保健专业人员协助的全面自我管理方法的重点开发。首选的交付方式是初始面对面咨询和电话随访。该手册在初级保健中对 37 名参与者进行了试点。主要结果测量包括自我报告慢性呼吸道问卷、递增穿梭步行试验和耐力穿梭步行试验（ESWT）；在基线和 6 周时进行测量。
该试点研究观察到自我报告慢性呼吸道问卷的呼吸困难领域和 ESWT 有统计学上的显著改善。呼吸困难的平均变化为 0.67（95%置信区间 0.23-1.11，P = 0.005）。ESWT 得分增加了 302.25 秒（95%置信区间 161.47-443.03，P < 0.001）。
本文描述了 COPD 新型自我管理方法的开发和实施。该计划，纳入了 SPACE for COPD 手册，似乎会引起初级保健中 COPD 患者的运动能力和呼吸困难的重要变化。
