title: Self-management and symptom monitoring among older adults with chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  To describe self-management, symptom monitoring and the associated influences among older adults with chronic obstructive pulmonary disease.
  
  
  BACKGROUND
  Optimal self-management and monitoring of key symptoms in patients with chronic obstructive pulmonary disease reduces dyspnoea and preventable hospitalizations.
  
  
  METHODS
  A prospective, descriptive survey design was used and data collected from patients with moderate severity chronic obstructive pulmonary disease during home interviews between April 2005 and June 2006. Predictors of self-management and symptom monitoring were determined by linear regression analyses.
  
  
  RESULTS
  Patients' (n = 78) mean age was 73.37 years (SD 7.52); 55.1% were male and 66.7% were married. Most (92.3%) had concurrent illnesses, and 48.7% had been admitted to hospital for chronic obstructive pulmonary disease in the past 6 months. Self-management was good to very good, with poorer self-management predicted by lower self-efficacy (beta = -0.21), a weaker sense of coherence (beta = -0.03), and no hospitalization in the past 6 months (beta = -05). Symptom monitoring was not ideal, with more than 20% of patients not monitoring any of the key symptoms. More frequent symptom monitoring occurred among participants who were married (beta = 5.14) and had more severe disease (beta = 0.79).
  
  
  CONCLUSIONS
  As self-management and symptom monitoring ensure better outcomes among patients with chronic obstructive pulmonary disease, health professionals should encourage these behaviours. Involving partners, promoting self-efficacy and understanding of sense of coherence are helpful in this process.
authors.affiliation: Faculty of Nursing, Midwifery & Health University of Technology, Sydney, Australia.
authors.forename: Melannie
authors.initials: M
authors.lastname: Warwick
authors.forename: Robyn
authors.initials: R
authors.lastname: Gallagher
authors.forename: Lynn
authors.initials: L
authors.lastname: Chenoweth
authors.forename: Jane
authors.initials: J
authors.lastname: Stein-Parbury
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D003371:Cough / Q000209:etiology; D004417:Dyspnea / Q000209:etiology; D005221:Fatigue / Q000209:etiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000523:psychology / Q000534:rehabilitation*; D012648:Self Care / Q000379:methods*; D020377:Self Efficacy