Despite the efficacy of pulmonary rehabilitation programs which assist patients
in managing chronic obstructive pulmonary disease (COPD), the high costs and lack of
availability of such programs pose considerable barriers for underserved COPD patients,
such as those living in rural communities. Because of this, patients are encouraged to
actively self-manage COPD. Unfortunately, COPD patients have reported dissatisfaction
with the self-management education they are provided. This mixed methods study
assessed the self-management learning needs of COPD patients treated at a Certified
Federal Rural Health Clinic through conducting focus group interviews (n = 2) to inform
the development a targeted self-management education DVD. The effectiveness of 3
distinct educational treatments (DVD vs. Pamphlet vs. DVD Pamphlet) was evaluated
by comparing outcomes related to informational needs, self-management self-efficacy,
and generic/lung-specific HRQoL in a randomly-assigned, multiple-group pretestposttest
design with a control group (n = 41). Focus group data was analyzed using three qualitative analysis tools. Findings
from the interviews indicated that patients viewed self-management as simply taking
prescribed medications and reducing activity. Patients reported a lack of knowledge and
skill development related to rehabilitative activities such as controlled breathing and
stress reduction.
A multivariate analysis of covariance was conducted to determine the effect of 3
educational treatments on multiple outcome measures. Three nontrend orthogonal
planned contrasts were tested to determine selected contrast effects. The data analysis
revealed that participants receiving a DVD reported statistically significantly higher
levels of lung-specific physical functioning as compared to those in the Pamphlet group.
Additionally, the DVD group revealed clinically significant improvements on the
physical ( 19.01) and emotional ( 10.74) functioning dimensions of lung-specific
HRQoL; whereas, no such improvement occurred within the Pamphlet and control
groups.
Results also suggested that providing patients with a Pamphlet alone was more
effective than providing participants with both interventions concurrently to increase
self-management self-efficacy. The simultaneous provision of both interventions did,
however, enhance generic HRQoL more so than the provision of one of the two
treatments alone. Finally, any type of self-management education as compared to usual
care did not statistically significantly improve outcome variables among this small
sample of rural patients.
| Identifer | oai:union.ndltd.org:tamu.edu/oai:repository.tamu.edu:1969.1/ETD-TAMU-2008-12-149 |
| Date | 14 January 2010 |
| Creators | Stellefson, Michael L. |
| Contributors | Ballard, Danny R. |
| Source Sets | Texas A and M University |
| Language | en_US |
| Detected Language | English |
| Type | Book, Thesis, Electronic Dissertation |
| Format | application/pdf |
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