Blackwell Publishing Journal Backfiles 1879-2005
Aim. This paper reports a study to determine whether a nurse-initiated telephone follow-up programme could increase patients’ self-efficacy in managing dyspnoea and decrease health care service use.Background. Chronic obstructive pulmonary disease is a worldwide health problem and has been labelled a burdensome disease. Because of the fear of activity-induced dyspnoea, patients with chronic obstructive pulmonary disease lack the confidence to perform daily activities. Studies of cardiac and diabetic patients have shown that telephone follow-up care is an effective approach to increasing self-efficacy. However, little such research has been done with patients with chronic obstructive pulmonary disease.Methods. This was a randomized controlled study. A total of 60 participants (30 telephone follow-up, 30 control) with chronic obstructive pulmonary disease were recruited from an acute care hospital in Hong Kong. The Chinese Self-Efficacy Scale was used to assess self-efficacy. Measures of health care use were numbers of visits to an accident and emergency department, hospitalizations, and unscheduled visits by physicians.Findings. The self-efficacy scores (U = 272·5, P = 0·009) of patients who were followed up by telephone improved significantly compared with those of patients in the control group. Multiple regression analyses showed that telephone follow-up (Beta = 0·33, CI: 0·19–0·48, P = 0·001), the pulmonary rehabilitation programme (Beta = 0·44, CI: 0·16–0·72, P = 0·003), smoking (Beta = 0·34, CI: 0·09–0·57, P = 0·009), and health care use (Beta = −0·27, CI: −0·47–(−0·07), P = 0·008) were significant factors in predicting patient self-efficacy.Conclusions. Nurse-initiated telephone follow-up care was effective in increasing self-efficacy in managing dyspnoea. The study needs to be replicated in other setting to strengthen its external validity.
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