Designing patient-related interventions in COPD care: empirical test of a theoretical model.
OBJECTIVE
The aim of this exploratory study was to test the applicability of a theoretical model to develop patient-related interventions. In this model knowledge, psychosocial mediators, self-efficacy and behaviour are determinants of patient-related interventions.


METHODS
The model was tested on 278 patients with mild or moderate chronic obstructive pulmonary disease (COPD), recruited in a primary care setting. Hierarchical regression analyses were applied using data from self-reported questionnaires and clinical data from an electronic data registry.


RESULTS
Knowledge, psychosocial mediators, self-efficacy and behaviour proved to be, to a moderate degree, predictors of outcomes in COPD care. Moreover, physical activity appeared to be a significant predictor for all clinical and functional outcomes.


CONCLUSIONS
Theoretically expected associations of patient-related interventions are existent in patients with mild or moderate COPD. The application of theoretical models in designing patient-directed interventions in COPD care is therefore feasible.


CONCLUSIONS
More attention should be paid to the patterns of physical activity in patients with mild to moderate COPD. The results of this study are also useful in the development of patient-related interventions. Future interventions should be designed along the lines of theory on behaviour change, such as social cognitive theory.
Erasmus University Medical Centre, Institute of Health Policy and Management, Rotterdam, The Netherlands. k.lemmens@erasmusmc.nl
K M M
KM
Lemmens
A P
AP
Nieboer
R
R
Huijsman
D001294:Attitude to Health; D003430:Cross-Sectional Studies; D005194:Family Practice; D005240:Feasibility Studies; D005260:Female; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D017145:Models, Educational; D008960:Models, Psychological; D020380:Needs Assessment; D009426:Netherlands; D010043:Outcome and Process Assessment, Health Care; D010347:Patient Care Planning / Q000458:organization & administration*; D010353:Patient Education as Topic / Q000458:organization & administration*; D018802:Patient-Centered Care / Q000458:organization & administration; D011594:Psychometrics; D029424:Pulmonary Disease, Chronic Obstructive / Q000517:prevention & control / Q000523:psychology; D012042:Registries; D012044:Regression Analysis; D012648:Self Care / Q000523:psychology; D020377:Self Efficacy; D011795:Surveys and Questionnaires