ผลของโปรแกรมสนับสนุนการจัดการตนเองต่อความสามารถในการจัดการอาการและอาการหายใจลำบากของผู้ป่วยโรคปอดอุดกั้นเรื้อรัง

Abstract

This quasi-experimental study aimed to evaluate the effect of a self-management support program on ability to manage symptoms and dyspnea among patients with chronic obstructive pulmonary disease. Fifty two subjects were purposively selected and assigned to either the experimental group (n=26) or the control group (n=26). The subjects were match on (1) sex, (2) age (± 5 years), and (3) level of disease (grade 1 and 2). The control group received usual nursing care while the experimental group received the self-management support program according to 5 A's techniques by Glasgow et al. (2006). The 5 A's techniques composed 5 steps: 1) assessing 2) advising 3) agreeing 4) assisting and 5) arranging. Data were collected from both groups at the first week and eighth week. The instrument for data collection was a self-management ability to manage dyspnea questionnaire and its reliability was examined using Cronbach's alpha coefficient (alpha= .79), and the instrument for measurement of Dyspnea was the Modified Medical Research Council Dyspnea Score: mMRC DS. The data were analyzed using descriptive statistics and the hypotheses were tested using Paired t-test and Independent t-test. The results revealed that after using the self-management support program, the experimental group had a significantly higher mean score of self- management ability to manage symptoms than that before (p<.001), and the self- management ability to manage symptoms in the experimental group was higher than that of the control group significantly (p<.001). The frequency of dyspnea severity after using the self-management support program was not significantly lower than that before (p>.05), and the frequency of dyspnea severity in the experimental group was lower than that of the control group significantly (p<.05). This finding indicated that the intervention program could increase ability to manage symptom and decrease dyspnea. Therefore, the Self-Management Support Program should be incorporated into nursing training to develop skills to support self-management in chronic obstructive pulmonary disease. The further study should focus on sustainability of program implementation.