Abstract
Objective
To compare the level of exercise self-efficacy, symptoms, functional capacity and health status and investigate the association between these variables in patients with chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF). Additionally, to investigate how diagnosis, symptoms and patient characteristics are associated with exercise self-efficacy in these patient groups.
Design
Cross-sectional study.
Setting
Primary care.
Subjects
Patients (n = 150) with COPD (n = 60), CHF (n = 60) and a double diagnosis (n = 30).
Main outcome measures
Swedish SCI Exercise Self-Efficacy score, modified Medical Research Council Dyspnea score (mMRC), fatigue score, pain severity score, Hospital Anxiety and Depression Scale, functional capacity measured as six-minute walking distance and health status measured by a Visual Analogue Scale.
Results
Levels of exercise self-efficacy, health status and symptoms were alike for patients with COPD and patients with CHF. Functional capacity was similar after correction for age. Associations with exercise self-efficacy were found for slight dyspnea (mMRC = 1) (R −4.45; 95% CI −8.41– −0.50), moderate dyspnea (mMRC = 2) (−6.60;−10.68– −2.52), severe dyspnea (mMRC ≥ 3) (−9.94; −15.07– −4.80), fatigue (−0.87;−1.41– −0.32), moderate pain (−3.87;−7.52– −0.21) and severe pain (−5.32;−10.13– −0.52), symptoms of depression (−0.98;−1.42– −0.55) and anxiety (−0.65;−0,10– −0.32), after adjustment for diagnosis, sex and age.
Conclusion and implications
Patients with COPD or CHF have similar levels of exercise self-efficacy, symptoms, functional capacity and health status. More severe symptoms are associated with lower levels of exercise self-efficacy regardless of diagnosis, sex and age. When forming self-management groups with a focus on exercise self-efficacy, it seems more relevant to consider level of symptoms than the specific diagnosis of COPD or CHF.
Exercise training is an important part of self-management in patients with COPD and chronic heart failure (CHF). High exercise self-efficacy is required for optimal exercise training.
Patients with COPD and CHF have similar symptoms and similar levels of exercise self-efficacy, functional capacity and health status.
Not the diagnosis, but symptoms of dyspnea, fatigue, pain, depression and anxiety are important factors influencing exercise self-efficacy and need to be addressed.
When forming self-management groups with a focus on exercise self-efficacy, it seems more relevant to consider the level of symptoms than the specific diagnosis of COPD or CHF.
Key points
Disclosure statement
No potential conflict of interest was reported by the author(s).