Effect of a Self-Regulation Enhancing Program on Practices in Using Inhaled Bronchodilators Among Older People with Chronic Obstructive Pulmonary Disease in Community Hospitals

Abstract

Older people with chronic obstructive pulmonary disease (COPD) often have difficulty controlling their dyspnea symptoms. One cause of this is the incorrect use of inhaled bronchodilators leading to ineffective medication administration. Therefore, self-regulation can help these people to gain the ability to control their thoughts and have appropriate behaviors. This quasi-experimental research aimed to study the effect of a self-regulation enhancing program on practices in using inhaled bronchodilators among older people with chronic obstructive pulmonary disease in communities. The participants included 50 persons aged 60-70 years, diagnosed with stage 3 COPD for at least three months. They were randomly assigned into an experimental group and a control group, with 25 cases per group. The duration of the program was five weeks with follow-up on the research results at the 8^th week. The research instruments consisted of 1) a self-regulation enhancing program based on Bandura's self-regulation concept, 2) a self-regulation manual to enhance practices in using inhaled bronchodilators, and 3) an assessment form on practices in using inhaled bronchodilators. The instruments were reviewed by six experts, resulting in a content validity index of 1.00 while reliability achieved an interclass correlation coefficient of 0.83. Data were analyzed using descriptive statistics, paired t-test, and independent t-test.

The research findings revealed that:
1. The experimental group had a higher mean score for practices of inhaled bronchodilator use after receiving the self-regulation enhancing program (Mean= 15.96, SD = .20) than before receiving the program (Mean = 9.80, SD = 1.68) with a statistical difference (t = -18.39, p < .001).
2. The experimental group had a higher mean score for practices of inhaled bronchodilator use after receiving the self-regulation promotion program (Mean = 15.96, SD = .20) than the control group receiving standard nursing care (Mean = 10.60, SD = 1.47) with a statistical difference (t = 18.04, p < .001).

This research study demonstrates that self-regulation enables older people with COPD to practice using inhaled bronchodilators correctly and effectively. Therefore, self-regulation strategies should be implemented to further promote proper medication use among older people with COPD.