Turner Ap, Anderson Jk, Wallace Lm, Kennedy-Williams P
Applied Research Centre in Health and Lifestyle Interventions, Coventry University, Coventry, UK
Applied Research Centre in Health and Lifestyle Interventions, Coventry University, Coventry, UK.
Chron Respir Dis. 2014 Aug 1;11(3):163-172. doi: 10.1177/1479972314539979. Epub 2014 Jun 30.
Self-management is becoming an important part of treatment for patients with chronic obstructive pulmonary disease (COPD). We conducted a longitudinal survey of patients with COPD who attended a 7-week group-based lay and clinician co-delivered COPD self-management programme (SMP)to see whether they became more activated, enjoyed better health status, and quality of life, were less psychologically distressed and improved their self-management abilities. The main analysis was a per-protocol analysis (N = 131), which included only patients who attended ≥5 SMP sessions and who returned a 6-month follow-up questionnaires. Changes in the mean values of the patient outcomes were compared over time using paired t tests and general linear model for repeated measures. Patient activation significantly improved 6 months after the SMP (p < 0.001). There were also significant improvements in COPD mastery (p = 0.001) and significant improvements in a range of self-management abilities (self-monitoring and insight p = 0.03), constructive attitude shift (p = 0.04), skills and technique acquisition, (p < 0.001)). This study showed that a lay and clinician-led SMP for patients with COPD has the potential to produce improvements in important outcomes such as activation, mastery and self-management abilities.
自我管理正成为慢性阻塞性肺疾病（COPD）患者治疗的重要组成部分。我们对参加了为期7周的由非专业人员和临床医生共同开展的COPD自我管理项目（SMP）的COPD患者进行了一项纵向调查，以了解他们是否变得更加积极主动、健康状况和生活质量是否得到改善、心理困扰是否减少以及自我管理能力是否提高。主要分析是符合方案分析（N = 131），仅包括参加了≥5次SMP课程并返回了6个月随访问卷的患者。使用配对t检验和重复测量的一般线性模型比较患者结局均值随时间的变化。SMP实施6个月后，患者的积极性显著提高（p < 0.001）。COPD掌握程度也有显著改善（p = 0.001），一系列自我管理能力（自我监测和洞察力p = 0.03）、建设性态度转变（p = 0.04）、技能和技术获取（p < 0.001）也有显著改善。这项研究表明，由非专业人员和临床医生主导的针对COPD患者的SMP有可能在激活、掌握程度和自我管理能力等重要结局方面产生改善。
