title: Self-management and quality of life in chronic obstructive pulmonary disease (COPD): The mediating effects of positive affect.
abstract: OBJECTIVE
  This study aimed to increase our understanding of general self-management (SM) abilities in COPD by determining if SM can predict disease specific quality of life (QoL), by investigating whether specific SM domains are significant in COPD and by exploring the mediating effect of the positive/negative affect in the association between SM and QoL.
  
  
  METHODS
  Cross-sectional study based on 292 patients with COPD. Measures included demographics, lung function, gait speed, health care utilization, positive/negative affect, SM abilities, breathlessness and disease specific QoL. We performed, correlation, multiple regression models and mediation analysis (positive/negative affect being mediator between SM and QoL association).
  
  
  RESULTS
  After controlling for breathlessness, living alone, marital status, hospitalization history, age and lung function, SM related to QoL (p<0.0001). Investment in behaviors (hobbies and social relationships) and self-efficacy are SM domains independently related to QoL in COPD. Positivity measured by the positive/negative affect ratio completely mediates the relationship of SM with QoL.
  
  
  CONCLUSIONS
  SM is independently associated with disease specific QoL in COPD after adjustment significant covariates but positive/negative affect ratio completely mediates the relationship of SM with QoL.
  
  
  CONCLUSIONS
  Measuring positive/negative affect and addressing investment behavior and self-efficacy are important in implementing COPD-SM programs.
authors.affiliation: Mindful Breathing Lab, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA. Electronic address: benzo.roberto@mayo.edu.
authors.forename: Roberto P
authors.initials: RP
authors.lastname: Benzo
authors.affiliation: Mindful Breathing Lab, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA; Instituto de Investigación Sanitaria Valdecilla, IDIVAL, Santander, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Abascal-Bolado
authors.affiliation: Mindful Breathing Lab, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Megan M
authors.initials: MM
authors.lastname: Dulohery
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004417:Dyspnea / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D005260:Female; D005684:Gait; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D000071066:Patient Reported Outcome Measures; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000503:physiopathology* / Q000523:psychology*; D011788:Quality of Life; D012129:Respiratory Function Tests; D012648:Self Care / Q000523:psychology*; D020377:Self Efficacy; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
keywords: COPD; Positive affect; Quality of life; Self-management