Adding Granularity of COPD Self-Management to Impact Quality of Life.

Abstract

Introduction Self-Management abilities (SM) are a recognized ingredient for living well with COPD, improving all outcomes. Fostering SM requires a personalized program and patient engagement to make lifestyle decisions. While some SM practices are proven effective, like the prompt use of a plan for COPD exacerbations, there is a guideline-recognized gap on specific SM behaviors that can impact particular COPD symptoms and allow for tailored SM programs. We aimed to investigate the association of well-defined self-management behaviors with the most common COPD symptoms in a large cohort of patients with COPD. Methods We analyzed baseline data of stable COPD patients that participated in three NIH-funded studies. Symptoms were defined by the four domains of the Chronic Respiratory Questionnaire: Dyspnea-Fatigue-Emotions-Mastery. The SM behaviors were the individual items of the SM Ability Scale-30. Lasso regression models were built to explore the association of behaviors with symptoms, adjusting for lung function and age. Results We analyzed 512 stable COPD patients, 54% female, age mean (SD) 69.6 (9.9) years, and FEV1% 42.2 (19.0). Dyspnea was associated with exercising and self-efficacy for self-care. Emotion was associated with good relationships, self-efficacy for self-care, positivity, and participating in agreeable activities. Fatigue was associated with self-efficacy for self-care, doing exercise, and participating in agreeable activities. Mastery was associated with self-efficacy for self-care, positivity, exercising, and participating in agreeable activities. Discussion Our findings provide specific SM behaviors associated with common COPD symptoms that may inform SM programs. Positive thinking represents a novel SM approach to COPD emotions and Mastery.