Development and Validation of a Chronic Obstructive Pulmonary Disease Self-Management Scale

Background: Although self-management reportedly can improve the health and quality of life of patients with chronic obstructive pulmonary disease (COPD), there is no validated instrument for evaluating the status of patients’ self-management on COPD.

Methods: A 51-item COPD Self-Management Scale (CSMS) including five domains (symptom management, daily life management, emotion management, information management, and self-efficacy) was developed and validated using data from 413 COPD patients.

Results: The CSMS showed good reliability and validity in the validation study. The test-retest correlation coefficient (CC) and the Cronbach’s alpha coefficient of the CSMS were 0.87 and 0.92, respectively. The content validity index of the CSMS was 0.90. The correlations of the CSMS with established COPD Self-Efficacy Scale (CSES), Chronic Disease Self-Management Behavior Scale (CDSMBS) and Chronic Disease Self-Efficacy Scale (CDSES) were 0.71, 0.61 and 0.66, respectively. The self-efficacy domain in the CSMS was highly correlated with the total score of the CSES (CC=0.82) and the CDSES (CC=0.76). Moreover, the total score of the CSMS were negatively correlated with the percentage of predicted values of forced expiratory volume in one second (FEV1 % Predicted), with a CC of -0.55. CSMS domain 1 (symptom management) and domain 2 (daily life management) had relatively high CCs (-0.57 and -0.64, respectively) with FEV1 % Predicted, indicating good criterion validity of the scale.

Conclusions: The CSMS is reliable, valid and sensitive for evaluating the selfmanagement status of COPD patients. It is the first dedicated scale for evaluating the self-management status of COPD patients, and will serve as an important instrument for assessing and improving the self-management of COPD patients, particularly, those in the Hunan region of China.