Internet-Based Support for Dyspnea Self-Management in Patients with COPD
Huong Q. Nguyen, RN, PhD, Department of Physiological Nursing, School of Nursing, University of California, San Francisco; Virginia Carrieri-Kohlman, RN, DNSc, Department of Physiological Nursing, School of Nursing, University of California, San Francisco; Sally H. Rankin, RN, PhD, Department of Family Health Care Nursing, School of Nursing, University of California, San Francisco; Robert Slaughter, PhD, Office of Research, School of Nursing, University of California, San Francisco; Michael S. Stulbarg, MD, Department of Pulmonary and Critical Care Medicine, School of Medicine, University of California, San Francisco

Findings Summary
The purpose of this study was to determine the feasibility and preliminary efficacy of a nurse-facilitated and peer supported Internet-based dyspnea self-management program (iDSMP) for patients with chronic obstructive pulmonary disease (COPD). A related aim was to compare the differential effects of the iDSMP with two groups; one to evaluate the program as a primary intervention and the other to test if the iDSMP could be used as an effective “booster.” Two
independent groups (n=16) participated in the iDSMP with the outcomes of dyspnea, self-efficacy for managing shortness of breath, and exercise behavior being evaluated at baseline and 3 months. The DSMP was comprised of four components: structured online education; peer and professional support; exercise goal setting and monitoring; and pulmonary function and symptom monitoring. Descriptive statistics, paired and independent t-tests were used and effect sizes were calculated. Subjects (87%) reported that the program increased their access to information and resources
for managing dyspnea. There were significant improvements in dyspnea with activities of daily living and self-efficacy for managing the symptom (both, p<0.01). Positive findings suggest additional investigations are warranted. Programs like the iDSMP could be helpful adjuncts to clinic contacts in promoting successful self-management for other chronic illnesses.

Learning Objective 1
Describe challenges to providing ongoing support for self-management in patients with COPD

Learning Objective 2
Analyze process and outcome data and implications for future investigations

Learning Objective 3
Identify specific opportunities for improving self-managment support interventions using eHealth applications

Dissemination Plan
A manuscript has been submitted to a peer-reviewed journal. Building on this study, two grants proposing to test the iDSMP more extensively with a randomized controlled design have been submitted to the NIH and RWJ. Once the program’s efficacy is clearly established, additional investigations into its effectiveness will be implemented.