Pulmonary Rehabilitation Improves Self-Management Ability in Subjects With Obstructive Lung Disease

• Published in: Respiratory care 2021-08, Vol.66 (8), p.1271-1281
• Main Authors: Janssen, Steffi Mj, Vliet Vlieland, Thea Pm, Volker, Gerard, Spruit, Martijn A, Abbink, Jannie J
• Format: Article
• Language: English
• Subjects: Female; Health Literacy; Humans; Lung diseases, Obstructive; Male; Original Research; Pulmonary Disease, Chronic Obstructive; Quality of Life; Self Care; Self-Management; Surveys and Questionnaires
• ISSN: 0020-1324; 1943-3654
• DOI: 10.4187/RESPCARE.07852

Optimizing self-management is a key element in multidisciplinary pulmonary rehabilitation in patients with asthma or COPD. This observational study aimed to investigate the changes in self-management following pulmonary rehabilitation in subjects with chronic lung disease. Data were prospectively and routinely gathered at initial assessment and discharge in subjects taking part in a 12-week multidisciplinary out-patient pulmonary rehabilitation program. Measures of self-management included the Patient Activation Measure (PAM), the Health Education Impact Questionnaire (HEIQ) (8 subscales), a Self-Efficacy Questionnaire (2 subscales), the Lung Information Needs Questionnaire (LINQ), and the Health Literacy Questionnaire (HLQ) (9 subscales). Mean differences with 95% CI and effect sizes were computed. A total of 70 subjects (62.9% women) were included, with a median age of 63.5 y; most of the subjects had been diagnosed with COPD (77%). Between admission and discharge, all measures of self-management increased significantly except for the HEIQ subscales of constructive attitudes and approaches, social integration and support, and health services navigation; and the HLQ subscale of social support for health. The largest improvements (effect size > 0.55) were seen for the PAM (0.57); the HEIQ subscales of health-directed behavior (0.71), self-monitoring and insight (0.62), and skill and technique acquisition (1.00); the HLQ subscales of having sufficient information to manage my health (1.21) and actively managing my health (0.66); and the LINQ (1.85). Self-management, including activation, improved significantly in subjects with asthma or COPD who took part in a multidisciplinary pulmonary rehabilitation program.