In a study utilizing different methodology, COPD patients’
self-care behavior was found to be negatively influenced
by depression, previous alcohol dependence, low
self-efficacy, and less perceived influence over COPD
symptoms, whereas patients with a self-management plan
had better knowledge and self-care behavior.30 Self-care
behavior in this context is an aspect of the patient’s self management plan, described for our study as the skills
needed by patients to adhere to COPD treatment regimens
and to change their health behavior in order to manage
their symptoms and lead functional lives. Although we did
not specifically measure depression, history of alcohol dependence, or other psychopathology and its impact on patient self-care behavior and family caregiver caring behavior, we did arrive at a conclusion regarding the effect of self-efficacy. The results of this study make an important
contribution to the literature, but in a direction unanticipated by other researchers. In their review of the literature on caregivers of COPD patients, Caress et al stated that few research reports have been published on effective and appropriate training of family caregivers of COPD patients, and that knowledge of the needs of caregivers is critical so that they can have the information they need to maintain their own physical and emotional health.8 Although we agree that caregivers’ needs must be understood and met, our results appear to discourage intensive training and involvement of family member caregivers, placing the responsibility for disease management instead on COPD patients themselves and also on the nature of the patient/caregiver relationship. This tends to imply that the amount of caregiving needed, and therefore the related caregiver burden, may influence both the quality of life of caregivers and also the caregiver/patient relationship. Relative to this, Pinto et al in 2007 investigated the effects of COPD on caregivers’ quality of life using a cross-sectional study conducted with 42 COPD patients and their caregivers; they concluded that COPD in a family member has a significant impact on the quality of the caregivers’ lives and that the relationship between patients and their caregivers was an important predictor of the COPD burden.7 In our study, a negative correlation between the scale of family caregiver caring behavior and the scale of self-care behavior of COPD patients showed that increasing the self-care behavior of COPD patients may reduce the burden on family caregivers providing day-to-day care. We also demonstrated a positive effect on patients’ self-care
behavior scale scores in patients whose spouse was the
primary caregiver; patients whose spouse was caregiver
exhibited higher self-care ability than patients not married
to their caregivers. These findings may support the idea
that a closer, more defined patient/caregiver relationship
contributes to a reduced caregiver burden due to the patient’s more willing role in self-care management, in other words, greater cooperation. This may also suggest placing less emphasis on intensive caregiver training and more emphasis on encouraging positive patient/caregiver relationships.