Self-management programmes for people living with chronic obstructive pulmonary disease: A call for a reconceptualisation

摘要

Aims and objectives: To synthesise findings from previously published studies on the effectiveness of self-management programmes for people with chronic obstructive pulmonary disease. Background: Self-management is a widely valued concept to address contemporary issues of chronic health problems. Yet, findings of self-management programmes for people with chronic obstructive pulmonary disease are indecisive. Design: Literature review of (1) previously published systematic reviews and (2) an integrative literature review. Method: Synthesis of findings from previously published systematic reviews (n=4) of the effectiveness of self-management programmes for people with chronic obstructive pulmonary disease and an integrated review that was performed on papers published between January 2007-June 2012 (n=9). Results: Findings demonstrate that there are few studies on the effectiveness of self-management programmes on people with chronic obstructive pulmonary disease despite more than a decade of research activities. Outcomes of the studies reveal some increase in health-related quality of life and reduction in use of healthcare resources. The methodological approaches vary, and the sample size is primarily small. Families are not acknowledged. Features of patient-centredness exist in self-management programmes, particularly in the more recent articles. Conclusions: The effectiveness of self-management programmes for people with chronic obstructive pulmonary disease remains indecisive. Relevance to clinical practice: A reconceptualisation of self-management programmes is called for with attention to a family-centred, holistic and relational care focusing on living with and minimising the handicapping consequences of the health problems in their entirety. ? 2013 Blackwell Publishing Ltd.