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Semin Respir Crit Care Med 2009; 30(6): 700-707
DOI: 10.1055/s-0029-1242639
© Thieme Medical Publishers

The Role of Collaborative Self-Management in Pulmonary Rehabilitation

Jean Bourbeau1 , 2
  • 1Division of Pulmonary Medicine, McGill University, Montréal, Québec, Canada
  • 2Montreal Chest Institute, McGill University Health Center, Montréal, Québec, Canada
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Publication History

Publication Date:
25 November 2009 (online)

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ABSTRACT

Self-management’s key feature is to increase patients’ involvement and control in their disease and improve their well-being. Self-management is not intended to replace components of patient health care such as medication and pulmonary rehabilitation. We may be enthusiastic about recent results of self-management programs in chronic obstructive pulmonary disease (COPD) patients showing a reduction in hospital admissions. However, being interested only in patients’ hospital admissions is overly narrow. The pivotal objective of self-management programs is to change patients’ behavior. The success should correspond to the goals of self-management (e.g., acquiring key self-management skills such as problem solving, decision making, early symptom recognition, and taking action) and self-health behaviors (maintaining comfortable breathing, implementing an action plan in the event of an exacerbation, and facilitating exercise maintenance). Pulmonary rehabilitation is increasingly becoming a realistic component of COPD patient management, but it should not stand as an isolated intervention. Pulmonary rehabilitation should be part of an integrated care process and include self-management support (i.e., aiming to achieve a shift from management by the health care provider to management by the patients themselves, which implies structural behavior change). Changing patient behavior and ensuring maintenance are complex processes and require time.

KEYWORDS

COPD - self-management - patient education - pulmonary rehabilitation

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Jean BourbeauM.D. 

Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute

3650 St.-Urbain St., K 1.32, Montréal, Québec, Canada H2X 2P4

Email: jean.bourbeau@mcgill.ca

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