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      Self-rated health aspects among persons living with chronic obstructive pulmonary disease

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          Abstract

          Purpose

          To describe a cohort of chronic obstructive pulmonary disease (COPD) patients and perform a within-group comparison regarding self-management activation, social provision, and health status.

          Patients and methods

          A cross-sectional survey including 116 persons.

          Results

          The sample comprised 65 men and 38 women, mean age 69 years. Fourteen percent reported very high impact of COPD on their health; 19% had received pulmonary rehabilitation offers, 39% had been offered self-management education, and 64% had acute hospital admissions due to COPD complications in the past year. Persons with COPD Assessment Test (CAT) scores ≥30 reported significantly poorer self-management activation and significantly lower social provision than those reporting CAT scores <30. Number of COPD years had no significant influence on COPD health care consultations or self-management activation.

          Conclusion

          Persons with COPD reported decreasing social provision with increasing COPD years and poorer health status. Although COPD is a progressive disease, health status and self-management activation did not vary with number of COPD years. Those living with a very high COPD impact on health reported significantly lower self-management activation but fewer acute hospital admissions.

          Practice implications

          COPD patients’ need for pulmonary rehabilitation, self-management support, and social support should be assessed and appropriate services offered throughout the disease trajectory.

          Related collections

          Most cited references 48

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          Development and testing of a short form of the patient activation measure.

          The Patient Activation Measure (PAM) is a 22-item measure that assesses patient knowledge, skill, and confidence for self-management. The measure was developed using Rasch analyses and is an interval level, unidimensional, Guttman-like measure. The current analysis is aimed at reducing the number of items in the measure while maintaining adequate precision. We relied on an iterative use of Rasch analysis to identify items that could be eliminated without loss of significant precision and reliability. With each item deletion, the item scale locations were recalibrated and the person reliability evaluated to check if and how much of a decline in precision of measurement resulted from the deletion of the item. The data used in the analysis were the same data used in the development of the original 22-item measure. These data were collected in 2003 via a telephone survey of 1,515 randomly selected adults. Principal Findings. The analysis yielded a 13-item measure that has psychometric properties similar to the original 22-item version. The scores for the 13-item measure range in value from 38.6 to 53.0 (on a theoretical 0-100 point scale). The range of values is essentially unchanged from the original 22-item version. Subgroup analysis suggests that there is a slight loss of precision with some subgroups. The results of the analysis indicate that the shortened 13-item version is both reliable and valid.
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            Self-management education: history, definition, outcomes, and mechanisms.

            Self-management has become a popular term for behavioral interventions as well as for healthful behaviors. This is especially true for the management of chronic conditions. This article offers a short history of self-management. It presents three self-management tasks--medical management, role management, and emotional management--and six self-management skills--problem solving, decision making, resource utilization, the formation of a patient-provider partnership, action planning, and self-tailoring. In addition, the article presents evidence of the effectiveness of self-management interventions and posits a possible mechanism, self-efficacy, through which these interventions work. In conclusion the article discusses problems and solutions for integrating self-management education into the mainstream health care systems.
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              Self management for patients with chronic obstructive pulmonary disease.

              Self management interventions help patients with chronic obstructive pulmonary disease (COPD) acquire and practise the skills they need to carry out disease-specific medical regimens, guide changes in health behaviour and provide emotional support to enable patients to control their disease. Since the first update of this review in 2007, several studies have been published. The results of the second update are reported here.
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                Author and article information

                Journal
                Int J Chron Obstruct Pulmon Dis
                Int J Chron Obstruct Pulmon Dis
                International Journal of COPD
                International Journal of Chronic Obstructive Pulmonary Disease
                Dove Medical Press
                1176-9106
                1178-2005
                2017
                12 April 2017
                : 12
                : 1163-1172
                Affiliations
                Faculty of Health Studies, Western Norway University of Applied Sciences, Førde, Norway
                Author notes
                Correspondence: Anne-Grethe Halding, Western Norway University of Applied Sciences, Høgskulen på Vestlandet, Postbox 7030, 5020 Bergen, Norway, Tel +47 48 12 96 03, Email anne.halding@ 123456hvl.no
                Article
                copd-12-1163
                10.2147/COPD.S129325
                5396837
                © 2017 Halding and Grov. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

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                Original Research

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