Purpose
This study was conducted to develop a conceptual framework for understanding non-adherence to self-management among patients with Chronic Obstructive Pulmonary Disease (COPD). This was accomplished through a literature review, in-depth interviews with patients, and a survey of healthcare professionals featuring semi-structured open-ended questions.
Methods
First, a systematic literature review was conducted across five databases. Next, 25 patients with COPD participated in detailed interviews that included seven semi-structured questions. Subsequently, 15 healthcare professionals completed a survey about factor categories and specific factors associated with non-adherence to COPD self-management. Categories and factors identified at least once across these three methods were documented. Finally, two researchers conducted preliminary mapping of the relationships between factor categories and individual factors, which was assessed for face validity by a third researcher. All processes were conducted from March 28, 2022, and January 30, 2023.
Results
The research revealed eight factor categories and 53 individual factors associated with non-adherence to COPD self-management. The categories encompassed personal, socioeconomic, disease-related, functional, treatment- related, health system-related, and environmental characteristics. The literature review, patient interviews, and survey of healthcare professionals yielded 35, 19, and 44 factors, respectively. Twelve factors were identified using all three sources. All processes were conducted from March 28, 2022, and January 30, 2023.
Conclusion
In this study, quantitative and qualitative methods were employed to develop a conceptual framework for non-adherence to COPD self-management. The findings indicate that effective self-management of this condition requires not only patient effort but also adaptations to complex treatment regimens, societal perceptions, and workplace environments.

Citations

• Development of a deep learning model to predict smoking status in patients with chronic obstructive pulmonary disease: A secondary analysis of cross-sectional national survey
  Sudarshan Pant, Hyung Jeong Yang, Sehyun Cho, EuiJeong Ryu, Ja Yun Choi
  DIGITAL HEALTH.2025;[Epub]     CrossRef
• Factors Associated with Non-Adherence to Self-Management Among Patients with Chronic Obstructive Pulmonary Disease: A Survey Using the Delphi Technique and Analytic Hierarchy Process
  Ja Yun Choi, Eui Jeong Ryu
  International Journal of Chronic Obstructive Pulmonary Disease.2024; Volume 19: 1247.     CrossRef

Purpose
Patients with pulmonary disease are more vulnerable to Particulate Matter (PM). It is important to promote health behaviors to minimize negative effects. This study aims to investigate risk perception, knowledge, and PM-related health behaviors in patients with pulmonary disease and identify the factors affecting PM-related health behaviors.
Methods
Participants were 201 patients with pulmonary disease who visited the outpatient clinic in a hospital. Data were collected using self-administered questionnaires and medical records from December 2019 to February 2020. The collected data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson’s correlation coefficient, and multiple regression analysis.
Results
The average score of PM-related health behaviors was 22.79±4.43. In multiple regression analysis, factors affecting PM-related health behaviors were participants with higher risk perception of PM (,p<.001) and with longer pulmonary disease (p=.006). Moreover, participants who smoked previously but not currently (p<.001) and had never smoked (p=.001) had higher level of health behaviors than those who smoke.
Conclusion
Patients with pulmonary disease reported to have high level of overall PM-related health behaviors, but their performance on health behaviors that required knowledge was reported to be insufficient. Therefore, a patient-tailored educational program is needed to improve PM-related health behaviors by emphasizing risk perception related to PM. Special attention should be given to smokers and patients who experience a short disease period to improve PM-related health behaviors.

Citations

• Development and Validation of the Dust Exposure Reduction Behavior Scale
  Sung Woo Hwang, Hyun Kyoung Kim
  Sage Open.2024;[Epub]     CrossRef
• Development and Effectiveness of the School‐Based Education Program for Coping With Particulate Matter
  Soo Hyun Cho, Won‐Oak Oh, Minhyun Suk, Soo Kyung Park
  Journal of School Health.2023; 93(11): 1016.     CrossRef
• An Exploratory Study on the Policy for Facilitating of Health Behaviors Related to Particulate Matter: Using Topic and Semantic Network Analysis of Media Text
  Hye Min Byun, You Jin Park, Eun Kyoung Yun
  Journal of Korean Academy of Nursing.2021; 51(1): 68.     CrossRef

PURPOSE
The purpose of this study was to identify the characteristics of nutritional status and its risk factors in patients with Chronic Obstructive Pulmonary Disease (COPD).
METHODS
Participants included 136 patients with COPD in Donga University hospital and Haeundae paik hospital in Busan city. The data, collected by a trained research assistant from January 10 to July 18, 2017, were analyzed using Fisher's exact test, the Mann-Whitney U test, and logistic regression analysis with SPSS/WIN 21.0.
RESULTS
Among the 136 patients with COPD, 31 (22.8%) had abnormal nutritional status. According to the results of the logistic regression analysis, gender (Odds Ratio [OR]=5.27, 95% Confidence Interval [CI]=1.18~23.49, p=.029), percent predicted forced expiratory volume in one second [FEV1%] (OR=1.04, 95% CI=0.92~0.99, p=.012), symptom experience (OR=16.19, 95% CI=3.08~85.00, p=.001), carbohydrate intake (OR=1.01, 95% CI=1.00~1.02, p=.037), protein intake (OR=1.06, 95% CI=0.90~0.99, p=.012), and fat intake (OR=1.04, 95% CI=1.01-1.08, p=.015) were associated with nutritional status in patients with COPD.
CONCLUSION
In order to improve the nutrutional status of COPD patients, nursing education is needed with intensive screen on female patients and patients with low lung function, managing symptoms and increasing protein intake.

PURPOSE
This study compares the characteristics of patients with Chronic Obstructive Pulmonary Disease (COPD) according to hospitalization frequency due to Acute Exacerbation (AE) using a retrospective medical records review.
METHODS
From August to October 2017, COPD patients who had visited the chonnam national university hospital were classified into three groups: (1) not hospitalization (n=115), (2) hospitalized once owing to AE (n=79) and (3) hospitalized twice or more owing to AE (n=47), and their medical records were reviewed. Data were analyzed using χ2, Kruskal Wallis, and Mann-Whitney tests, and logistic regression.
RESULTS
Home oxygen therapy, metered dose inhaler use, long-acting beta2-agonist, and Inhaled Corticosteroids (ICS) were used most in patients who were hospitalized twice or more. Symptoms of dyspnea and fever, prescription of phosphodiesterase-4 and oral corticosteroid were the least frequent in the patients who were not hospitalized, and they had the best pulmonary function test results. Home oxygen therapy (Odds Ratio [OR]=9.59, 95% Confidence Interval [CI]=2.53~36.46), and prescribed ICS (OR=2.77, 95% CI=1.14~6.77) and phosphodiesterase-4 (OR=5.35, 95% CI=1.69~16.93) were significantly associated with COPD readmission. For patients who were hospitalized once, SpO2 (p=.016), the frequency of positive pressure ventilation therapy (p=.023) and monitoring of oxygen saturation in nursing activities (p=.022) were higher than that of patients who were hospitalized twice or more. There was no significant difference in discharge education between the two hospitalized groups.
CONCLUSION
Regardless of the severity of illness, presence of respiratory symptoms, drug prescribed, or admission frequency, there were no differences in nursing activities and discharge education.

Citations

• COPD Prevalence and Risk Factors in Korean Older Adults
  Do-Youn Lee
  The Journal of Korean Physical Therapy.2025; 37(1): 31.     CrossRef
• Development of a smartphone application for Korean patients with chronic obstructive pulmonary disease: Self-monitoring based action plans
  Ja Yun Choi, Maureen George, So Young Yun
  Applied Nursing Research.2021; 61: 151475.     CrossRef

PURPOSE
This study was conducted to develop and test an explanatory model on functional capacity in patients with chronic obstructive pulmonary disease using path analysis. METHODS: Data were collected from 149 chronic obstructive pulmonary disease patients using 6-minute walk test, measurement of oxygen saturation, pulmonary function test, and self-reported questionnaires from June to October, 2005. The collected data were analyzed using SPSS/WIN 12.0 program and AMOS/WIN 4.0 program. RESULTS: The overall fitness indices of modified model were good( chi-square = 14.324, p = .281 GFI = .981, RMSEA = .006, AGFI = .944, NFI = .927, NNFI = .999, CFI = .999, PNFI = .613, chi-square /df = 1.194). Functional capacity was influenced directly by age(beta = -.304, p = .000), dyspnea(beta = -.278, p = .000), self-efficacy(beta = .240, p = .000), social support(beta = .175, p = .004), pulmonary function(beta = .169, p = .008), and oxygen saturation(beta = .099, p = .048). These variables explained 39.3% in functional capacity. CONCLUSION: The findings of this study suggest that comprehensive nursing interventions should focus on decreasing dyspnea and increasing self-efficacy, social support, and oxygen saturation. In this perspective, pulmonary rehabilitation would be an effective strategy for improving functional capacity in patients with chronic obstructive pulmonary disease.

PURPOSE
This study aimed to define the relationship among self-care, symptom experiences, and health-related quality of life(HRQoL) according to the severity of disease in chronic obstructive pulmonary disease(COPD) patients.
METHODS
The participants, 195 COPD patients, were recruited at a pulmonology clinic of a universityaffiliated medical center in B metropolitan city. Inclusion criteria were patients who were diagnosed as COPD and had less than 0.7 of FEV1/FVC(Forced Expiratory Volume for 1 second/Forced Vital Capacity) ratio. The severity was classified with GOLD(Global initiative for Obstructive Lung Disease) stages, FEV1% predicted value from mild to very severe. The data were gathered by the medical records and self-reported questionnaires.
RESULTS
The self-care, symptom experience, and HRQoL were all significantly different by COPD severity based on pulmonary function(p<.05). There were significant moderate negative relationships between symptom experiences and self-care(r=-.54, p<.001) and between symptom experiences and HRQoL(r=-.64, p<.001). There was a moderate positive correlation between self-care and HRQoL(r=.63, p<.001).
CONCLUSION
It suggests that the assessment of disease severity based on pulmonary function and subjective symptom experience in patients with COPD may be a key component to develop a tailored self-management program and to improve their quality of life.

The purpose of the study was to investigate two areas as a basis for providing an educational program for pulmonary rehabilitation. A) the learning needs about chronic obstructive pulmonary disease in patients with chronic obstructive pulmonary disease and B) the perception of nurses of the same learning needs. The subjects consisted of 57 patients, with chronic obstructive pulmonary disease, at the general hospital in Seoul and 71 nurses, who were working in the medical ward. Data was obtained from a "learning need" questionnaire between October 29 and November 19, '99. Data was analyzed using SAS program for t-test, ANOVA, Scheff test. The result were as follows: 1. The learning needs of the nurses(mean 4.36 +/- .38) were higher than those of the patients (mean 3.56 +/- .83). (t=6.78, P=.001) 2. The highest ranked patient education needs were as follows ; a)"how to control dyspnea", b)"cause for activating dyspnea", and c)"how to minimize the necessity of oxygen in daily living": and nurses' learning needs were ; a)"how to cope with the risk situation", b)"management after discharge", and c)"how to control dyspnea". 3. In the patient group, those who had a college degree or higher education and paid their own hospital expenses were higher in the learning needs. According to the above results, we should consider an educational program which is realistic and effective for patients by evaluating the items the patients really want to learn about and how much they know about the evaluated items.