Study of Older Adults' Use of Self-Regulation for COPD Self-Management Informs An Evidence-Based Patient Teaching Plan

PURPOSE: People with chronic obstructive pulmonary disease (COPD) have frequent hospitalizations and emergency department visits, often due to COPD exacerbations which worsen disease status. Recognizing exacerbations is challenging; patients must distinguish between day-to-day COPD symptom variations and exacerbation symptoms. Self-regulation theory (Bandura, 1999) is useful for understanding symptom recognition, interpretation, and response. In this article a qualitative study of self-regulation use by 28 older adults with COPD (Brandt, 2005) is summarized. METHODS: Twenty-eight community-dwelling older adults were interviewed. Data were analyzed using the interpretive description method. RESULTS AND DISCUSSION: Informants used self-regulation behaviors in varying degrees. Most attended primarily to their breathing, comparing their usual degree of breathlessness and intensifying their everyday self-management practices if breathlessness worsened. CLINICAL RELEVANCE: A theory- and evidence-based COPD teaching plan for use by rehabilitation nurses is presented that includes attention to exacerbation recognition.