title: The development and pilot testing of the self-management programme of activity, coping and education for chronic obstructive pulmonary disease (SPACE for COPD).
abstract: OBJECTIVE
  There is no independent standardized self-management approach available for chronic obstructive pulmonary disease (COPD). The aim of this project was to develop and test a novel self-management manual for individuals with COPD.
  
  
  METHODS
  Participants with a confirmed diagnosis of COPD were recruited from primary care.
  
  
  METHODS
  A novel self-management manual was developed with health care professionals and patients. Five focus groups were conducted with individuals with COPD (N = 24) during development to confirm and enhance the content of the prototype manual. The Self-management Programme of Activity, Coping and Education for Chronic Obstructive Pulmonary Disease (SPACE for COPD) manual was developed as the focus of a comprehensive self-management approach facilitated by health care professionals. Preference for delivery was initial face-to-face consultation with telephone follow-up. The SPACE for COPD manual was piloted with 37 participants in primary care. Outcome measures included the Self-Report Chronic Respiratory Questionnaire, Incremental Shuttle Walk Test, and Endurance Shuttle Walking Test (ESWT); measurements were taken at baseline and 6 weeks.
  
  
  RESULTS
  The pilot study observed statistically significant improvements for the dyspnea domain of the Self-Report Chronic Respiratory Questionnaire and ESWT. Dyspnea showed a mean change of 0.67 (95% confidence interval 0.23-1.11, P = 0.005). ESWT score increased by 302.25 seconds (95% confidence interval 161.47-443.03, P < 0.001).
  
  
  CONCLUSIONS
  This article describes the development and delivery of a novel self-management approach for COPD. The program, incorporating the SPACE for COPD manual, appears to provoke important changes in exercise capacity and breathlessness for individuals with COPD managed in primary care.
authors.affiliation: National Institute of Health Research CLAHRC-LNR Pulmonary Rehabilitation Research Group, University Hospitals of Leicester NHS, Leicester, UK. lindsay.d.apps@uhl-tr.nhs.uk
authors.forename: Lindsay D
authors.initials: LD
authors.lastname: Apps
authors.forename: Katy E
authors.initials: KE
authors.lastname: Mitchell
authors.forename: Samantha L
authors.initials: SL
authors.lastname: Harrison
authors.forename: Louise
authors.initials: L
authors.lastname: Sewell
authors.forename: Johanna E
authors.initials: JE
authors.lastname: Williams
authors.forename: Hannah Ml
authors.initials: HM
authors.lastname: Young
authors.forename: Michael
authors.initials: M
authors.lastname: Steiner
authors.forename: Mike
authors.initials: M
authors.lastname: Morgan
authors.forename: Sally J
authors.initials: SJ
authors.lastname: Singh
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D054626:Consumer Health Information / Q000379:methods / Q000458:organization & administration; D004417:Dyspnea / Q000628:therapy*; D017598:Efficiency, Organizational; D005080:Exercise Test; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D010358:Patient Participation; D010865:Pilot Projects; D016730:Program Development; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D012648:Self Care / Q000379:methods / Q000523:psychology
keywords: Endurance Shuttle Walking Test; Self-Report Chronic Respiratory Questionnaire; dyspnea; primary care; self-management