{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T21:11:40Z","timestamp":1788383500037,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,3,26]],"date-time":"2020-03-26T00:00:00Z","timestamp":1585180800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Older People Nursing"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims and design<\/jats:title><jats:p>Various healthcare services in Japan provide self\u2010management interventions for older people with chronic obstructive pulmonary disease (COPD). To examine the influence of healthcare service utilisation on self\u2010management activities, we conducted a cross\u2010sectional survey of older people with COPD who received care through outpatient clinics (OC), outpatient rehabilitation centres (OR) or home care (HC) services.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The survey consisted of 34 originally developed self\u2010report questions about three types of self\u2010management activities: (a) strategies to minimise dyspnoea, (b) appropriate activities to maintain physical and mental health status and (c) communication with healthcare professionals or family members. We compared self\u2010management activities in each setting (OC, OR and HC) using logistic regression analyses, controlling for dyspnoea level and age, which we chose as representative variables of disease severity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among the total sample (<jats:italic>n<\/jats:italic>\u00a0=\u00a081; mean age: 78.2\u00a0years old), participants in the HC group (<jats:italic>n<\/jats:italic>\u00a0=\u00a025) had the most severe level of COPD, followed by those in the OR (<jats:italic>n<\/jats:italic>\u00a0=\u00a031) and OC (<jats:italic>n<\/jats:italic>\u00a0=\u00a012) groups. Compared with participants from the OC group, more participants from the OR and HC groups reported self\u2010management activities, such as \u201cmoving body corresponding to breathing\u201d (OR: adjusted odds ratio [AOR], 6.71; HC: AOR, 6.98), \u201ctrying not to move quickly\u201d (OR: AOR, 5.46), \u201cavoiding suffocating movements\u201d (HC: AOR, 7.37), \u201cgetting an influenza vaccination\u201d(OR: AOR, 8.12; HC: AOR, 7.81), \u201cstretching exercise\u201d (OR: AOR, 6.42; HC: AOR, 16.76), \u201cmuscle training\u201d (OR: AOR, 8.49; HC: AOR, 9.73) and \u201cdiscussing lifestyle goals with healthcare professionals\u201d (HC: AOR, 5.75) after controlling for dyspnoea level and age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Some self\u2010management activities (such as breathing techniques and home exercise) were associated with the use of OR or HC services, an effect persisting after adjusting for degree of breathlessness and age.<\/jats:p><\/jats:sec><jats:sec><jats:title>Implications for practice<\/jats:title><jats:p>Findings suggest that we should provide additional services such as OR and HC besides OC to older people with COPD who are unable to practice self\u2010management activities.\u00a0We need to consider strategies to provide effective self\u2010management intervention in each healthcare service setting according to the unique characteristics of each setting.<\/jats:p><\/jats:sec>","DOI":"10.1111\/opn.12316","type":"journal-article","created":{"date-parts":[[2020,3,26]],"date-time":"2020-03-26T10:09:45Z","timestamp":1585217385000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Self\u2010management activities of older people with chronic obstructive pulmonary disease by types of healthcare services utilised: A cross\u2010sectional questionnaire study"],"prefix":"10.1111","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1452-2283","authenticated-orcid":false,"given":"Satomi","family":"Kitamura","sequence":"first","affiliation":[{"name":"Department of Gerontological Home Care and Long\u2010term Care Nursing\/Palliative Care Nursing Division of Health Sciences and Nursing Graduate School of Medicine The University of Tokyo Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5292-8893","authenticated-orcid":false,"given":"Ayumi","family":"Igarashi","sequence":"additional","affiliation":[{"name":"Department of Gerontological Home Care and Long\u2010term Care Nursing\/Palliative Care Nursing Division of Health Sciences and Nursing Graduate School of Medicine The University of Tokyo Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuhiro","family":"Yamauchi","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine The University of Tokyo Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideaki","family":"Senjyu","sequence":"additional","affiliation":[{"name":"Department of Clinical Mycobacteriosis Unit of Mycobacteriosis Nagasaki University Graduate School of Biomedical Sciences Nagasaki Japan"},{"name":"Department of Respiratory Care and Rehabilitation Center Fukujuji Hospital Japan Anti\u2010Tuberculosis Association Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9365-5804","authenticated-orcid":false,"given":"Takeo","family":"Horie","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine Maebashi Redcross Hospital Gunma Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1704-7011","authenticated-orcid":false,"given":"Noriko","family":"Yamamoto\u2010Mitani","sequence":"additional","affiliation":[{"name":"Department of Gerontological Home Care and Long\u2010term Care Nursing\/Palliative Care Nursing Division of Health Sciences and Nursing Graduate School of Medicine The University of Tokyo Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,3,26]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.54.7.581"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0738-3991(03)00102-2"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2648.2008.04821.x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2011.11.005"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1843.2004.00637.x"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-172X.2008.00709.x"},{"key":"e_1_2_9_8_1","volume-title":"Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary 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