title: Effects of nurse-initiated telephone follow-up on self-efficacy among patients with chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  This paper reports a study to determine whether a nurse-initiated telephone follow-up programme could increase patients' self-efficacy in managing dyspnoea and decrease health care service use.
  
  
  BACKGROUND
  Chronic obstructive pulmonary disease is a worldwide health problem and has been labelled a burdensome disease. Because of the fear of activity-induced dyspnoea, patients with chronic obstructive pulmonary disease lack the confidence to perform daily activities. Studies of cardiac and diabetic patients have shown that telephone follow-up care is an effective approach to increasing self-efficacy. However, little such research has been done with patients with chronic obstructive pulmonary disease.
  
  
  METHODS
  This was a randomized controlled study. A total of 60 participants (30 telephone follow-up, 30 control) with chronic obstructive pulmonary disease were recruited from an acute care hospital in Hong Kong. The Chinese Self-Efficacy Scale was used to assess self-efficacy. Measures of health care use were numbers of visits to an accident and emergency department, hospitalizations, and unscheduled visits by physicians.
  
  
  RESULTS
  The self-efficacy scores (U = 272.5, P = 0.009) of patients who were followed up by telephone improved significantly compared with those of patients in the control group. Multiple regression analyses showed that telephone follow-up (Beta = 0.33, CI: 0.19-0.48, P = 0.001), the pulmonary rehabilitation programme (Beta = 0.44, CI: 0.16-0.72, P = 0.003), smoking (Beta = 0.34, CI: 0.09-0.57, P = 0.009), and health care use (Beta = -0.27, CI: -0.47-(-0.07), P = 0.008) were significant factors in predicting patient self-efficacy.
  
  
  CONCLUSIONS
  Nurse-initiated telephone follow-up care was effective in increasing self-efficacy in managing dyspnoea. The study needs to be replicated in other setting to strengthen its external validity.
authors.affiliation: Department of Medicine, Tseung Kwan O Hospital, Hong Kong SAR, China. shirleywkw@yahoo.com.hk <shirleywkw@yahoo.com.hk>
authors.forename: Kwan Wai
authors.initials: KW
authors.lastname: Wong
authors.forename: Frances K Y
authors.initials: FK
authors.lastname: Wong
authors.forename: Moon Fai
authors.initials: MF
authors.lastname: Chan
mesh_terms: D000359:Aftercare / Q000379:methods; D000368:Aged; D000369:Aged, 80 and over; D003695:Delivery of Health Care / Q000706:statistics & numerical data; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011594:Psychometrics; D029424:Pulmonary Disease, Chronic Obstructive / Q000451:nursing* / Q000523:psychology; D012648:Self Care; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D013689:Telephone