Symptom burden and self-management in persons with chronic obstructive pulmonary disease

Purpose: Self-management is crucial for effective COPD management. This study aimed at identifying associations between self-management and sociodemographic characteristics, clinical characteristics, and symptom burden in people with COPD. Patients and methods: In this cross-sectional study with 225 participants diagnosed with COPD grades II-IV, multiple linear regression analysis was conducted, using sociodemographic and clinical characteristics and symptom burden (COPD Assessment Test) as the independent variables and the eight self-management domains of the Health Education Impact Questionnaire (heiQ) as the outcome variables. Results: Higher symptom burden was significantly associated with worse scores in all self-management domains (p< 0.003), except for self-monitoring and insight (p= 0.012). Higher disease severity (p= 0.004) and numbers of comorbidities (p< 0.001) were associated with more emotional distress, and women scored higher than men on positive and active engagement in life (p= 0.001). Higher score in pack-years smoking was associated with lower score in health-directed activities (p= 0.006) and self-monitoring and insight (p< 0.001), and participation in organized physical training was associated with higher score in health-directed activities (p< 0.001). The final models explained 3.7%-31.7% of variance (adjusted R-2) across the eight heiQ scales. Conclusion: A notable finding of this study was that higher symptom burden was associated with worse scores in all self-management domains, except for self-monitoring and insight. In addition, sex, disease severity, comorbidity, pack-years smoking, and participation in organized physical training were associated with one or two self-management domains. The study contributes to improved understanding of self-management in COPD. However, the explained variance levels indicate that more research needs to be done to uncover what else explains self-management domains in COPD.