Predicting poor self-management behaviors in adults with newly diagnosed COPD: based on the information-motivation-behavioral skills model.

BACKGROUND

Self-management is an important measure to control the development of chronic obstructive pulmonary disease (COPD), but the self-management ability of newly diagnosed COPD patients can not be evaluated. Therefore, this study aims to develop and verify a risk prediction model based on the information-motivation-behavioral skills (IMB) model to predict poor self-management behaviors in newly diagnosed COPD patients.

METHODS

In this prospective cohort study, a total of 331 adults with COPD were recruited from a general hospital in Chengdu, China. Data were collected at baseline based on the IMB model, such as cognitive function, social support, frailty, depressive and anxiety symptoms, and patient activation. Self-management behaviors were evaluated as the outcome variable after one-year follow up. Multivariate logistic regression was used to develop a risk prediction model to predict poor self-management behaviors. The nomogram was used to perform and visualise the predictive model and the receiver operator characteristic (ROC) curve, external validation were applied to evaluate the prediction performance of the model.

RESULTS

A total of 331 patients completed follow-up (222 in the development cohort and 109 in the validation cohort). 68.3% of the participants occurred poor self-management behaviors. Cognitive function, patient activation, and depression were independent predictors for poor self-management behaviors for COPD patients. A nomogram was established based on regression analysis, and the AUC of this nomogram was 0.945. The sensitivity and specificity were 89.68% and 91.04% respectively. The AUC of the validation cohort was 0.898 and the Hosmer-Lemeshow test indicated good model prediction.

CONCLUSIONS

The risk prediction model based on IMB model and a nomogram including 3 easily available prediction factors (cognitive function, patient activation and depression) on poor self-management behaviors for newly diagnosed COPD patients was established, which showed good discrimination, and calibration. It can be used to screen out high- risk population with poor self-management behaviors for newly diagnosed COPD patients early.