Effects of nurse-initiated telephone follow-up on self-efficacy among patients with chronic obstructive pulmonary disease

Aim. This paper reports a study to determine whether a nurse-initiated telephone follow-up programme could increase patients' self-efficacy in managing dyspnoea and decrease health care service use. Background. Chronic obstructive pulmonary disease is a worldwide health problem and has been labelled a burdensome disease. Because of the fear of activity-induced dyspnoea, patients with chronic obstructive pulmonary disease lack the confidence to perform daily activities. Studies of cardiac and diabetic patients have shown that telephone follow-up care is an effective approach to increasing self-efficacy. However, little such research has been done with patients with chronic obstructive pulmonary disease. Methods. This was a randomized controlled study. A total of 60 participants (30 telephone follow-up, 30 control) with chronic obstructive pulmonary disease were recruited from an acute care hospital in Hong Kong. The Chinese Self-Efficacy Scale was used to assess self-efficacy. Measures of health care use were numbers of visits to an accident and emergency department, hospitalizations, and unscheduled visits by physicians. Findings. The self-efficacy scores (U = 272(.)5, P = 0(.)009) of patients who were followed up by telephone improved significantly compared with those of patients in the control group. Multiple regression analyses showed that telephone follow-up (Beta = 0(.)33, CI: 0(.)19-0(.)48, P = 0(.)001), the pulmonary rehabilitation programme (Beta = 0(.)44, CI: 0(.)16-0(.)72, P = 0(.)003), smoking (Beta = 0(.)34, CI: 0(.)09-0(.)57, P = 0(.)009), and health care use (Beta = -0(.)27, CI: -0(.)47-(-0(.)07), P = 0(.)008) were significant factors in predicting patient self-efficacy. Conclusions. Nurse-initiated telephone follow-up care was effective in increasing self-efficacy in managing dyspnoea. The study needs to be replicated in other setting to strengthen its external validity.