Self-care approaches to managing chronic obstructive pulmonary disease: a provincial survey.
Chronic obstructive pulmonary disease (COPD) is a common chronic respiratory condition associated with considerable personal and social burden yet little is known about how patients manage their condition. The purpose of this study was to identify, from the perspective of individuals living with COPD, their management approaches. A mailed survey was conducted with individuals living in Ontario with physician confirmed COPD who experienced daily respiratory symptoms. Potential participants were identified through existing databases. Questionnaire development was based on focus groups and pilot testing. Completed questionnaires were received from 353 of the 452 eligible participants, representing a 78% response rate. The mean age of responders was 68 +/- 12 years (sd) with 52% male, 85% ex-smokers, 52% with moderate COPD (self-report) and 52% treated by a family physician. Common strategies used by participants included inhaled bronchodilators (100%), annual influenza vaccination (90%), aerobic types of activity (75%), regular physician visits (72%), breathing exercises (69%) and inhaled steroids (67%). Forty-four percent of participants had scores indicative of depression. Participants (68%) reported using a shared decision-making model for management decisions and were satisfied with their interactions with the health care team (physician and non-physician). Most individuals with COPD use several strategies to manage their disease. Health care professionals have an important role in ensuring that evidence-based guidelines for COPD are translated to patients.