title: Factors influencing self-management in chronic obstructive pulmonary disease: an integrative review.
abstract: BACKGROUND
  Chronic obstructive pulmonary disease is a common, chronic and burdensome condition requiring the individual to engage in a range of self-management strategies. The capacity to engage in self-management is dependent on a range of internal (e.g., personal) and external (e.g., health service) factors.
  
  
  OBJECTIVE
  This paper seeks to define self-management, identify the determinants which influence the individual's ability to cope and adjust to living with chronic obstructive pulmonary disease in the community, and identify implications for clinical practice and research.
  
  
  METHODS
  Integrative review.
  
  
  METHODS
  Medline, Embase, PubMed, CINAHL, Google Scholar.
  
  
  METHODS
  Integrative review using prospective research questions. Papers were included in the review if they were published in peer reviewed journals and written in English between 2000 and 2010. Articles were accepted for inclusion if they discussed the determinants that influenced self-management of chronic obstructive pulmonary disease in the community. Confirmation of results and discussion themes was validated by specialists in chronic obstructive pulmonary disease and complex care.
  
  
  RESULTS
  Self-management is less well characterised in chronic obstructive pulmonary disease compared with other chronic conditions. Functional limitation and the need to balance disease management with everyday life are the two key elements that patients face in managing their condition. Provider characteristics, socioeconomic status and health literacy are sparsely discussed yet are known to influence chronic obstructive pulmonary disease self-management.
  
  
  CONCLUSIONS
  Chronic obstructive pulmonary disease self-management must be a key focus internationally as the disease incidence increases. Collaborative care is required between patients and health providers in order facilitate patients in confident management of their condition.
authors.affiliation: Faculty of Nursing Midwifery and Health, University of Technology Sydney, Sydney, Australia. Rebecca.disler@uts.edu.au
authors.forename: R T
authors.initials: RT
authors.lastname: Disler
authors.forename: R D
authors.initials: RD
authors.lastname: Gallagher
authors.forename: P M
authors.initials: PM
authors.lastname: Davidson
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D006297:Health Services Accessibility; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000523:psychology / Q000534:rehabilitation*; D012648:Self Care / Q000523:psychology; D020377:Self Efficacy; D012944:Social Support; D029181:Spirituality