Roles of Advanced Practice Nurses for Self-Management Support in New Older Patients of Chronic Obstructive Pulmonary Disease with an Acute Exacerbation: A Case Study

Abstract

Abstract: Elderly patients with newly diagnosed chronic obstructive pulmonary disease (COPD) experiencing acute exacerbation often have complex issues that require specialized care to enhance their ability to self-manage appropriately. This case study presents self-management support by an advanced practice nurse, using the self-management support concept based on the Chronic Care Model. This model is a process that helps patients manage and avoid factors that lead to breathing difficulties and acute exacerbations, as well as enabling them to make informed decisions about health behaviors through six steps:1) Setting mutual goals between the patient and the healthcare team; 2) Collecting data through self-monitoring, self-observation, and recording personal information; 3) Processing and evaluating the data to help the patient learn about their own illness; 4) Making decisions based on the gathered information regarding their illness. 5) Taking action to manage and control factors that lead to acute exacerbations; and 6) Self-reflection: evaluating the actions taken to meet the set goals, as well as promoting continuous behavior change to prevent and avoid triggers that cause acute exacerbations. The advanced practice nurse used various competencies to support self-management continuously, from the crisis phase through rehabilitation. The results showed that patients were able to adjust their behaviors to prevent and avoid triggers that lead to acute exacerbations, resulting in improving outcomes, such as no readmissions within 28 days, and reducing acute exacerbation rate.