Factors Related to Activation in Chinese Patients With Chronic Obstructive Pulmonary Disease: A Cross-Sectional Survey Study

Background: Improving patient activation can lead to better health outcomes among patients with chronic obstructive pulmonary disease (COPD). However, no studies have focused on the issue of activation in patients with COPD in China. Purpose: This study was designed to explore the status of activation in patients with COPD in China and explicate the significant influencing factors. Methods: One hundred seventy patients with COPD were recruited using a convenience sampling method from eight tertiary and secondary hospitals in Nanjing, China. Socio-demographic, clinical, and patient-reported factor data were collected. Univariate analysis and multivariate linear regression were performed. Results: Only 10.6% of the patients were identified as activated for self-management. Multivariate linear regression analysis revealed four explanatory elements as significantly associated with patient activation, including social support (β= .463, p ＜ .001), free medical insurance (β= .173, p = .007), smoking status (β= -.195, p = .002), and health status (β= -.139, p = .04). Conclusions/Implications for Practice: The findings of this study indicate that a minority of patients with COPD are activated for self-management in China. Having a higher level of patient activation was associated with having better social support, having free medical insurance, being a nonsmoker, and having a better health status. Creating a supportive environment, promoting smoking cessation, and improving medical security and health status may be considered as potential strategies to activate patients into better self-management.