Promotion of Self Management of Chronic Obstructive Pulmonary Disease in the Community

Background: Chronic obstructive pulmonary disease (COPD) is an increasingly prevalent disease, characterized by severe morbidity and mortality. The chronic nature of the disease accounts for its significant socioeconomic burden. It impairs the health related quality of life of patients to a degree that depends on the stage of the disease and the management of the symptoms. Aim: The aim of this literature review was to examine the most relevant interventions for the promotion of self management in patients with COPD, and to describe the facilitating factors and the obstacles to effective self management of COPD in the primary health care setting. Method: A literature review in the electronic databases Medline, CINAHL, PsycINFO, Scopus was carried out, covering the years 1999–2009, using the keywords: COPD self management, self management interventions, self management programmes, chronic disease management, patient outcomes. Results: Factors that have been found to facilitate COPD self management include social support, communication with other patients, and family support. Depression, fatigue, difficulty in performing regular physical exercise, social isolation, lack of control over their lives and dependence upon other people for performance of daily living activities were the main barriers to self management in patients with COPD. Nurses can promote COPD self management by providing support for patients in coping with their disease and managing their symptoms. Conclusions: Self management aims to improve the ability of patients with COPD to manage their symptoms and treatment, to cope with the social and psychological impact of their disease and to implement the changes in lifestyle that the disease imposes. Self management programmes can contribute to decreasing the frequency of hospitalization and improving the quality of life of patients with COPD.