A complex intervention of self-management for patients with COPD or CHF in primary care improved performance and satisfaction with regard to own selected activities; A longitudinal follow-up

Abstract

Aim: To test a self-management intervention in primary health care (PHC) for patients with chronic obstructive pulmonary disease (COPD) or chronic heart failure (CHF) on self-efficacy, symptoms, functioning, and health.

Background: Patients with COPD or CHF experience often the same symptoms such as shortness of breath, cough, lack of energy, dry mouth, numbness or tingling in hands and feet, pain and sleeping problems.

Design: A multicentre randomized control trial.

Method: The trial was conducted with one intervention group (N = 73) and one control group (N = 77). The trial was performed from September 2013-September 2015 at nine PHC centres in three county councils in Sweden. At baseline patients with COPD and CHF experienced any symptom. Follow-ups were performed after 3 months and 1 year. The intervention was structured on Bandura's theory of self-efficacy in six meetings and individual action plans based on personal problems were performed and discussed.

Results: At baseline, there were no differences between the groups except for SF-36 social function. After 3 months, the intervention group improved performance and satisfaction with regard to own selected activities, otherwise no differences were found.

Conclusion: When designing a program, the patient's own difficulties must be taken into consideration if person-centred care is to be established. It is feasible to include both patients with COPD and CHF in the same group in PHC. Healthcare professionals need supervision in pedagogics during intervention in self-management.

Keywords: chronic heart failure; chronic obstructive pulmonary disease; nurses; patient education; primary health care; self-management support.