Effect of a Health Belief Model-based nursing intervention on Chinese patients with moderate to severe chronic obstructive pulmonary disease: a randomised controlled trial

J Clin Nurs. 2014 May;23(9-10):1342-53. doi: 10.1111/jocn.12394. Epub 2013 Sep 19.


Aims and objectives: To test the effect of a Health Belief Model-based nursing intervention on healthcare outcomes in Chinese patients with moderate to severe COPD.

Background: The Health Belief Model (HBM) has been internationally validated in a variety of chronic conditions. However, nursing intervention based on the HBM is less explored in Chinese patients with COPD.

Design: A randomised controlled trial.

Methods: Enrolled patients were randomly assigned to the intervention and control groups. Patients in the intervention group received a 20- to 30-minute HBM-based nursing intervention every 2 days during the hospitalisation period after disease conditions were stable, with additional follow-ups after discharge. Patients in the control group received routine nursing care.

Results: Patients had significantly increased scores of health belief and self-efficacy after receiving the HBM-based nursing intervention. After receiving the 3-month follow-up, patients in the intervention group had significantly higher mean total scores in the Health Belief Scale and the COPD Self-Efficacy Scale, as well as in all the subscales, than those in the control group except the perceived disease seriousness. Results showed that the value of FEV1 /FVC ratio had a significant difference between study groups before and after the intervention. Results also indicated that mean scores of the Dyspnea Scale, 6-minute walking distance and ADL were significantly different between the groups and between the study time-points.

Conclusions: Among patients with moderate to severe COPD, nursing intervention based on the HBM can enhance their health belief and self-efficacy towards the disease management, decrease dyspnoea and improve exercise tolerance and ADL.

Relevance to clinical practice: Nurses can use the HBM-based intervention to enhance patients' health belief and self-efficacy towards the management of COPD, and subsequently benefit healthcare outcomes.

Keywords: chronic obstructive pulmonary disease; health belief model; nursing intervention; pulmonary function; self-efficacy.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Asian People
  • Continuity of Patient Care*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Models, Nursing*
  • Pulmonary Disease, Chronic Obstructive / nursing*
  • Pulmonary Disease, Chronic Obstructive / pathology
  • Pulmonary Disease, Chronic Obstructive / psychology
  • Self Efficacy*
  • Severity of Illness Index
  • Treatment Outcome