This study compared the effects on self-efficacy of participation by patients with chronic obstructive pulmonary disease (COPD) in a pulmonary rehabilitation program that combined education and supervised exercise training with the results demonstrated by participation in a program that provided education alone. Thirty-seven patients participated in the pulmonary rehabilitation program, and 22 patients participated in the education-only program. Self-efficacy, as it effects managing or avoiding breathing difficulty, was measured before and after the programs. Patients' self-efficacy scores significantly improved after the pulmonary rehabilitation program and remained significantly improved 6 months later. Education alone was also effective in significantly improving self-efficacy scores, but patients' scores 6 months later were not significantly better than preprogram scores. This study indicates that a rehabilitation program that combines education and exercise training is more effective in improving long-term self-efficacy in patients with COPD.

The predominant debilitating symptom in patients with chronic obstructive pulmonary disease (COPD) is shortness of breath. Self-efficacy theory has been used in a case study approach to begin examining the expectations of a patient with COPD who attended a pulmonary education program. Mr. M. was selected for the case study because his condition typifies many of the problems encountered by patients with COPD. Mr. M.'s self-confidence in managing his breathing difficulty was measured by using the COPD Self-Efficacy Scale (CSES) before an educational program began and again 1 month and 6 months after the program. The CSES measures patients' confidence in their ability to manage or avoid breathing difficulty in a variety of situations. Mr. M.'s scores on the CSES improved in most areas. Incorporating programs to increase patients' self-efficacy may have implications for rehabilitation nurses who help patients with COPD manage their breathing difficulty.