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.