Determinants of self-management capacity of patients with Chronic Obstructive Pulmonary Disease: A cross sectional study.

Abstract

Background: Self-management is a pivotal element in COPD management, but a substantial proportion of COPD patients does not respond to self-management interventions. Little is known about determinants associated with self-management capacity. Aim and research questions: Understanding key determinants of self-management capacity to be able to identify patients at risk of inadequate engagement in self-management, which is essential to target and tailor self-management interventions. Research questions were: Which combination of determinants is associated with self-management capacity? What is the prevalence of different levels of self-management capacity? And which determinants are associated with a high risk of poor self-management capacity? Method: An explorative, cross-sectional study was conducted in primary and secondary care from January 2013 until June 2013. COPD patients above 40 years were recruited to answer a questionnaire measuring determinants and self-management capacity. Univariate and multiple linear regression analyses were performed. Results: A total of 296 COPD patients were included. Only 14% of the participants was capable of self-management. Self-management capacity was associated with health status, anxiety, depression, illness perception, Body Mass Index (BMI), educational level, current working and dyspnea (P<0.05). Determinants associated with poor self-management capacity were partly different. Four explanatory determinants of self-management capacity were revealed: illness perception, depression, BMI and age (P<0.1). Conclusion: Illness perception, depression, BMI and age are key determinants of self-management capacity. This knowledge may help health care professionals to identify of patients at risk of inadequate engagement in self-management, which is essential to make a first step in targeting and tailoring of self-management interventions. There is a large potential for improvements in self-management capacity of COPD patients. Recommendations: Future research is needed to identify causal relationships between determinants and self-management capacity. This knowledge is essential to eliminate barriers of self-management capacity and will contribute to targeting and tailoring of self-management interventions.