Self-management practice, associated factors and its relationship with health literacy and patient activation among multi-morbid COPD patients from rural Nepal

Abstract

Background: Chronic Obstructive Pulmonary Disease (COPD) is a progressive and debilitating condition that affects individuals' quality of life. COPD self-management and supports provided by carers is key to the quality of life people living with COPD. Health literacy (HL) and Patient Activation (PA) are main drivers of self-management practices (SMPs). However, their contribution remains to be fully explored. This study aimed to examine the level of self-management practices, and the relationship with socio-demographic factors, HL and PA among multi-morbid COPD patients from rural Nepal. Methods: This is a cross-sectional study conducted between July 2018 and January 2019. Patients completed a survey, including Self-management Practices questionnaire (SMPQ), five domains of the Health Literacy Questionnaire (HLQ), and Patient Activation Measure (PAM). The relationship between HL, PAM, and SMPs was examined using univariate statistics. Multivariable analysis was conducted to identify the factors associated with SMPs. Results: A total of 238 patients responded to the study. The mean score of SMPQ was 45.31(SD = 9.00). The HLQ and PAM scores were positively correlated with the total score of SMPQ. Low level of SMPs were found to be positively associated with being uneducated (β = − 0.43, p = .001), having a low family income (β = − 5.22, p = .002), and, negatively associated with the presence of more than one co-morbidity (β = 3.58, p = 0.007) after controlling for other socio-demographic variables in the multivariable analysis. Conclusion: The overall SMPs among this sample of Nepalese with COPD were low. Our findings highlight the need to implement a self-management intervention program involving patient activation and health literacyfocused activities for COPD, creating a support system for patients from low-income families and low education.

Prevalence and correlates of Multimorbidity among older adults in rural Nepal: a cross sectional study

“…Signi cant differences in multimorbidity by ethnicity were noted: minority groups, particularly the Madhesi ethnic group, were slightly more likely to suffer from multimorbidity than the upper caste groups. Our nding is consistent with previous literature from Nepal, which documented a higher burden of chronic disease among the Madhesi ethnic group [22,27]. Historically, the Madhesi ethnic group was considered disadvantaged in the society as they were discriminated against by the upper caste groups and had limited access to education and employment [28].…”

Perceived Fear of COVID-19 and its Associated Factors Among Nepalese Older Adults in Eastern Nepal: Findings From a Cross-Sectional Study

“…Another possible explanation could be that those with chronic conditions have already developed resilience to dealing with major disease conditions which may have helped to develop perceived con dence to managing COVID-19, should they be infected. Furthermore, motivation and support from family members are important in chronic disease management in Nepal (25). Thus our participants with pre-existing conditions may have bene ted from their social support, which may have made them feel safer and consequently lessen the fear.…”

Using a co-design process to develop an integrated model of care for delivering self-management intervention to multi-morbid COPD people in rural Nepal

“…This phase involved a mixed-method study to describe existing self-management practices among the population in rural Nepal and examine how they thought and felt about their health care needs. The quantitative [ 33 , 34 ] component assessed the level of health literacy, patient activation and self-management practices of rural older people with COPD. The qualitative study [ 35 ] explored the facilitators and barriers to self-management among COPD patients from the perspective of both patients and primary HCPs.…”