Study finds link between social support and self-care behaviors in adults with COPD

People with COPD are more likely to be active and to participate in pulmonary rehabilitation if they live with others and have a caregiver, according to new research published online, ahead of print in the Annals of the American Thoracic Society.

In "Association between Social Support and Self-Care Behaviors in Adults with Chronic Obstructive Pulmonary Disease," researchers report on a study of 282 patients with COPD and whether having social support makes a difference in whether they engage in healthy behaviors.

"Patient engagement in self-care is the crux of COPD management," said senior study author Huong Q. Nguyen, PhD, RN, a research scientist at Kaiser Permanente Southern California and an affiliate associate professor at the University of Washington. "Our goal with this study was to identify factors associated with self-care activities, including physical activity, quitting smoking, participating in a pulmonary rehabilitation program, adherence to medications, and getting influenza and pneumococcal vaccinations."

Participants in the study (average age 68) were recruited from two Veterans Administration hospitals and two academic medical centers and had moderate to severe COPD. Eighty percent were white men, 90 percent reported having a family caregiver and 75 percent lived with others (family member or friends).

The researchers looked at the association between healthy behaviors and two kinds of social support: structural, the type of social network a person has such as being married or living with a partner or caregiver, and functional, the support a person perceives his/her social network provides. The latter was measured by means of a validated questionnaire. As might be expected, those who lived with others also reported high functional support.

The researchers found that participants who

• lived with others took 903 more steps each day;
• had a spouse or partner caregiver were 11 times more likely to participate in pulmonary rehabilitation;
• scored higher on the functional social support questionnaire, were more likely to receive a pneumococcal vaccination, and slightly less likely to smoke.

Neither type of social support was associated with higher levels of influenza vaccination or medication adherence.

Dr. Nguyen said that clinicians should assess whether their patients have the necessary social support to do all they can do to remain healthy. When social support is lacking, she added, the health care team should assist patients "in marshalling social support. Similarly, health and social policies should acknowledge and consider ways to support the nearly 45 million unpaid family caregivers in the United States who are responsible for the vast majority of the day-to-day care of their loved ones."

Study limitations that might affect its generalizability to the general population include the large number of men and veterans in the study, the use of pulmonary rehabilitation programs for recruitment of many participants and not taking into account factors such as transportation, access, and insurance coverage that might explain why some participated in pulmonary rehabilitation and others did not.