title: The effect of nurse-led problem-solving therapy on coping, self-efficacy and depressive symptoms for patients with chronic obstructive pulmonary disease: a randomised controlled trial.
abstract: OBJECTIVE
  to examine the effects of nurse-led, problem-solving therapy (PST) on coping, self-efficacy and depressive symptoms for patients with chronic obstructive pulmonary disease (COPD) using a randomised controlled trial.
  
  
  METHODS
  a total of 254 patients with COPD were recruited, screened and randomly allocated into the intervention group with nurse-led PST or the comparison group with usual care. A total of 151 patients (intervention = 78 and comparison = 73) completed the study for 6 months.
  
  
  METHODS
  the nurse-led PST was an individualised and patient-centred intervention to improve patients' problem-solving skills related to symptom management and lifestyle modification. Twelve telephone-based PST sessions were provided to the intervention group, while the control group received usual care from their primary care providers.
  
  
  RESULTS
  there were no group differences of post-test scores in problem-oriented coping, self-efficacy and depressive symptoms between the two groups. However, despite the lack of group differences, the nurse-led PST was effective for clinically depressed patients with COPD, who experienced decreased depressive symptoms (mean difference = 6.8, P = 0.009) and increased self-efficacy (mean difference = -0.6, P = 0.041) in the intervention group (n = 12).
  
  
  CONCLUSIONS
  the nurse-led PST offered to patients with COPD did not demonstrate any different effects compared with usual care over 6 months; however, a subgroup analysis with clinically depressed subjects showed improved self-efficacy and decreased depressive symptoms in the intervention group.
authors.affiliation: College of Nursing, Pusan National University, Yangsan, Republic of Korea.
authors.forename: Haejung
authors.initials: H
authors.lastname: Lee
authors.affiliation: School of Nursing, University of Wisconsin-Madison, Madison, WI, USA.
authors.forename: Ju Young
authors.initials: JY
authors.lastname: Yoon
authors.affiliation: College of Nursing, Pusan National University, Yangsan, Republic of Korea.
authors.forename: Yeonjung
authors.initials: Y
authors.lastname: Lim
authors.affiliation: Department of Nursing, Pusan Women's College, Pusan, Republic of Korea.
authors.forename: HeeYoung
authors.initials: H
authors.lastname: Jung
authors.affiliation: College of Nursing, Pusan National University, Yangsan, Republic of Korea.
authors.forename: Sungmin
authors.initials: S
authors.lastname: Kim
authors.affiliation: Department of Nursing, Ulsan College, Ulsan, Republic of Korea.
authors.forename: Younja
authors.initials: Y
authors.lastname: Yoo
authors.affiliation: Department of Internal Medicine, Pusan National University, Yangsan Hospital, Yangsan, Republic of Korea.
authors.forename: Yunseong
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Ulsan University Hospital, Ulsan, Republic of Korea.
authors.forename: Jong-Joon
authors.initials: JJ
authors.lastname: Ahn
authors.affiliation: Department of Internal Medicine, Pusan National University, Yangsan Hospital, Yangsan, Republic of Korea.
authors.forename: Hye-Kyung
authors.initials: HK
authors.lastname: Park
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D003863:Depression / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D008297:Male; D011340:Problem Solving; D029424:Pulmonary Disease, Chronic Obstructive / Q000451:nursing* / Q000523:psychology; D040242:Risk Reduction Behavior; D020377:Self Efficacy
keywords: COPD; coping; depressive symptoms; older people; problem-solving therapy; self-efficacy