Does self-management ability improve after pulmonary rehabilitation for chronic obstructive pulmonary disease?

Abstract

Background and Aims: Optimizing self-management is a key element in multidisciplinary pulmonary rehabilitation (PR), however research in this area is scarce. This study aimed to investigate the changes in self-management using various outcome measures after a pulmonary rehabilitation program. Methods: Data were prospectively and routinely gathered at initial assessment and discharge in patients taking part in a 12-week multidisciplinary outpatient PR program. Measures included the Patient Activation Measure (PAM), the Health Education Impact Questionnaire (HEIQ), a Self Efficacy (SE) questionnaire, the Lung Information Needs Questionnaire (LINQ) and the Health Literacy Questionnaire (HLQ). Mean differences with 95% confidence interval and effect sizes (ES) were computed. Results: 70 patients were included, 26 (37.1%) were men, with a median age of 63.5 years. Between admission and discharge all measures of self-management increased significantly, except for the HEIQ subscales Constructive attitudes and approaches; Social integration and support; and Health services navigation; and the HLQ subscale Social support for health. The largest improvements (ES>0.55) were seen for the PAM (0.57), the HEIQ subscales Health directed behaviour (0.71), Self-monitoring and insight (0.62) and Skill and technique acquisition (1.00), the HLQ subscales Having sufficient information to manage my health (1.21) and Actively managing my health (0.66) and the LINQ (1.85). Conclusion: According to various outcome measures, self-management, including activation, improves significantly in patients with asthma or COPD taking part in a multidisciplinary pulmonary rehabilitation program.