Effects of nurse-initiated telephone follow-up on self-efficacy among patients with chronic obstructive pulmonary disease

J Adv Nurs. 2005 Jan;49(2):210-22. doi: 10.1111/j.1365-2648.2004.03280.x.


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.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Aftercare / methods
  • Aged
  • Aged, 80 and over
  • Delivery of Health Care / statistics & numerical data
  • Female
  • Health Behavior
  • Humans
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / statistics & numerical data
  • Psychometrics
  • Pulmonary Disease, Chronic Obstructive / nursing*
  • Pulmonary Disease, Chronic Obstructive / psychology
  • Self Care
  • Self Efficacy*
  • Surveys and Questionnaires
  • Telephone*