title: Living With Chronic Obstructive Pulmonary Disease: The Process of Self-Managing Chronic Obstructive Pulmonary Disease.
abstract: BACKGROUND
  Disease self-management for patients with chronic obstructive pulmonary disease (COPD) is less well characterized than that for patients with other chronic diseases. A patient-centered perspective calls for qualitative research to investigate the process of self-management as a means of enhancing quality of life in patients with COPD.
  
  
  OBJECTIVE
  This study explores the process of self-management for patients with COPD and the factors that impact the efficacy of this process.
  
  
  METHODS
  A qualitative inquiry approach was used to collect data in the thoracic ward, outpatient department, and respiratory therapy room of a medical center in Taiwan. A convenience sample of 19 patients was collected. Qualitative content analysis was used to analyze data.
  
  
  RESULTS
  Living with COPD is a process that involves self-regulation and selecting suitable healthcare behaviors. The related healthcare behaviors identified in this study include symptom management, exercise implementation, environmental control, emotional adjustment, maintenance of a healthy life style, and utilization of community and healthcare resources. The factors that were found to influence this process include the physical and psychological conditions of the patient, his or her disease-related cognition, and the social support that he or she receives. In this study, once participants became dissatisfied with the consequences of their healthcare behaviors, they chose a new set of healthcare behaviors and continued to engage in the process of self-regulation.
  
  
  CONCLUSIONS
  Patients naturally become experts with regard to their lives through a process of trial and error. Even so, healthcare professionals play a key role in the process of self-management and help patients with COPD cope with various problems in their daily lives. The findingsof this study contribute to the development of evidence-based self-management interventions that promote quality of life in patients with COPD.
authors.affiliation: 1RN, PhD, Assistant Professor, School of Nursing, College of Medicine, Chang Gung University 2MD, Attending Physician, Department of Thoracic Medicine, Chang Gung Memorial Hospital and Chang Gung University 3RN, PhD, Professor, School of Nursing, College of Medicine, Chang Gung University 4RN, MSN, Supervisor, Department of Nursing, Chang Gung Memorial Hospital-Linkou Branch.
authors.forename: Kang-Hua
authors.initials: KH
authors.lastname: Chen
authors.forename: Chien-Ying
authors.initials: CY
authors.lastname: Liu
authors.forename: Yea-Ing Lotus
authors.initials: YI
authors.lastname: Shyu
authors.forename: Shu-Ling
authors.initials: SL
authors.lastname: Yeh
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000223:Adaptation, Psychological; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D002908:Chronic Disease / Q000523:psychology*; D006801:Humans; D008297:Male; D010361:Patients / Q000523:psychology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000451:nursing*; D036301:Qualitative Research; D011788:Quality of Life / Q000523:psychology*; D012648:Self Care / Q000523:psychology*; D013624:Taiwan