Self-management and symptom monitoring among older adults with chronic obstructive pulmonary disease.

AIMS To describe self-management, symptom monitoring and the associated influences among older adults with chronic obstructive pulmonary disease. BACKGROUND Optimal self-management and monitoring of key symptoms in patients with chronic obstructive pulmonary disease reduces dyspnoea and preventable hospitalizations. METHOD A prospective, descriptive survey design was used and data collected from patients with moderate severity chronic obstructive pulmonary disease during home interviews between April 2005 and June 2006. Predictors of self-management and symptom monitoring were determined by linear regression analyses. RESULTS Patients' (n = 78) mean age was 73.37 years (SD 7.52); 55.1% were male and 66.7% were married. Most (92.3%) had concurrent illnesses, and 48.7% had been admitted to hospital for chronic obstructive pulmonary disease in the past 6 months. Self-management was good to very good, with poorer self-management predicted by lower self-efficacy (beta = -0.21), a weaker sense of coherence (beta = -0.03), and no hospitalization in the past 6 months (beta = -05). Symptom monitoring was not ideal, with more than 20% of patients not monitoring any of the key symptoms. More frequent symptom monitoring occurred among participants who were married (beta = 5.14) and had more severe disease (beta = 0.79). CONCLUSION As self-management and symptom monitoring ensure better outcomes among patients with chronic obstructive pulmonary disease, health professionals should encourage these behaviours. Involving partners, promoting self-efficacy and understanding of sense of coherence are helpful in this process.