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Int J Nurs Pract. 2017 Feb;23(1). doi: 10.1111/ijn.12509. Epub 2017 Jan 4.

Demographic, health behavioral, and self-management abilities associated with disease severity among patients with chronic obstructive pulmonary disease: An exploratory study.

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School of Nursing, Tianjin Medical University, Tianjin, China.
Department of Respiratory Care, Tianjin First Center Hospital, Tianjin, China.


This study aimed to identify the association between demographic characteristics, health behaviors, self-management abilities, and disease severity among patients with chronic obstructive pulmonary disease (COPD). The study was conducted from January to December 2015 in 4 hospitals in China. The DOSE index was assessed by grade of dyspnea (D), airflow obstruction (O), current smoking status (S), and frequency of exacerbation in the last year (E). Self-management abilities were assessed by the COPD self-management scale. DOSE index associations with demographic characteristics, health behaviors, and self-management abilities were examined with multiple regression analysis. In total, 100 participants were recruited into the study. In univariate analysis, higher symptom management, lower daily life management, and lower self-efficacy in self-management abilities were significantly related to higher DOSE index. In multiple regression analysis, physical activity, body mass index, and gender were negatively related to DOSE index. The study highlighted the importance of physical activity, nutritional status, and gender difference in managing disease severity in COPD. Professional nurses should develop individualized intervention programs and specifically increase physical activity for men and poor nutritional status for patients with COPD.


chronic obstructive pulmonary disease; health behaviors; nurses; nutrition; physical activity; self-management

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