ReviewFactors influencing self-management in chronic obstructive pulmonary disease: An integrative review☆
Section snippets
Background
Chronic obstructive pulmonary disease (COPD) is one of the most common and burdensome chronic conditions globally. COPD affects 80 million people worldwide and is the fourth most prevalent cause of death. COPD also accounts for 3.5% of total years lost due to disability (YLD). As populations age in the developed world and smoking rates and the use of bio-fuels rise in emergent economies, such as China, the burden of COPD internationally is set to increase by 30% over the next 20 years (WHO, 2004
Aims
This integrative review sought to facilitate a comprehensive review of the influences on self-management in COPD and to develop a conceptual model to illustrate this.
Design
Using the method of an integrative review this paper sought to explore the influences on self-management in COPD. An integrative approach allows for a broad review of both empirical and theoretical literature in order to comprehensively understand complex concepts, theories or healthcare problems (Whittemore and Knafl, 2005). This
Selected papers
The process of paper selection and exclusion is demonstrated in Fig. 2. Through literature searching 29,070 papers were identified as related to COPD and 46,353 related to self-management. 550 of those papers related to COPD and self-management. 430 papers met the inclusion criteria of being written in the English language and published between the years 2000 and 2010. 162 of these papers were retrieved for detailed examination after review of abstracts and removal of duplications. Of these
Discussion
As outlined self-management is a complex construct and influenced by a range of factors. Understanding the diverse factors contributing to self-management is important in developing tailored and targeted interventions and supporting individuals to self-care. It is also important to consider the individuals interaction with health and social systems and the influence of socioeconomic factors on health status and self-management. The conceptual model developed through this integrative review (
Conclusion
COPD is a progressive and debilitating condition requiring complex self-management behaviours. A diverse range of physical, social, cultural, psychological and existential issues influence the individuals’ capacity to self-manage. Appreciating this complex interplay is critical for supporting individuals and their families in living with COPD.
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This paper was shortlisted for the International Network for Doctoral Research in Nursing (INDEN) Award, sponsored by the International Journal of Nursing Studies. The award is open to current doctoral students and those who have graduated from a doctoral programme within the past 12 months.