title: Does a self-management education program have the same impact on emotional and functional dimensions of HRQoL?
abstract: Most previous research evaluating the effect of interventions on HRQoL in COPD patients has focused on measuring HRQoL using aggregated questionnaire scores, increasing the risk of false-negative results. There is also evidence to suggest that self-evaluations of functional status are less likely to be modified over time relative to self-evaluation of emotional status. This study was a secondary analysis of a prospective study that compared the efficacy of a self-management education program (SM) on emotional and functional dimensions of HRQoL. One hundred and ten patients were recruited from the Sacré-Coeur Hospital of Montreal (Canada). Patients were included in either the SM group (n = 60) or the usual-care group (UC, n = 50). The SM group underwent a 4-week intervention based on content featured in "Living Well with COPD" program. Patients were assessed pre and 12-months post-intervention; the primary outcome was net change in the emotional and functional subscales scores of the St-George's Respiratory Questionnaire (SGRQ) and Short-Form health survey questionnaire (SF-36). Only the emotional dimension scores of both the SGRQ (impact) and the SF-36 (mental component summary) were statistically and clinically improved in the SM group compared to UC. Also, the 12-month adjusted between-group difference in the SGRQ-impact scores was 3-fold higher than the minimum clinically important difference in SM vs. UC patients. HRQoL needs to be regarded as a combination of distinct self-evaluations with unique dynamics over time. This distinction should be taken into account in program development and evaluation, to choose intervention components likely to impact on both types of self-evaluations related to HRQoL.
authors.affiliation: Montreal Behavioural Medicine Centre, Hôpital du Sacré-Coeur de Montréal -a University of Montreal affiliated hospital, Québec, Canada.
authors.forename: Grégory
authors.initials: G
authors.lastname: Moullec
authors.forename: Hélène
authors.initials: H
authors.lastname: Favreau
authors.forename: Kim L
authors.initials: KL
authors.lastname: Lavoie
authors.forename: Manon
authors.initials: M
authors.lastname: Labrecque
mesh_terms: D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008297:Male; D010353:Patient Education as Topic; D015397:Program Evaluation; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000628:therapy*; D011788:Quality of Life; D012648:Self Care; D012720:Severity of Illness Index