Abstract / Summary
Abstract Purpose To explore the temporal changes and temporal predictive associations between quality of life and self‑management ability among elderly patients with chronic obstructive pulmonary disease (COPD), so as to provide a basis for developing individualized and phased intervention measures. Methods In this two-wave observational cohort study, 350 elderly in‑hospital patients with stable COPD were conveniently recruited from the respiratory and critical care medicine departments of two tertiary hospitals in Ningxia from November 2020 to May 2021. Assessments were conducted before hospital discharge (T1) and at the third‑year follow‑up after discharge (T2) using the general information questionnaire, COPD Assessment Test (CAT), and COPD Self‑Management Scale. Repeated‑measures analysis of variance and cross‑lagged panel model were adopted for data analysis. Results A total of 246 out of 350 eligible elderly patients with COPD completed follow-up,with an attrition rate of 29.71%. Repeated‑measures analysis of variance showed statistically significant main effects of survey time (F = 11.73, P = 0.001; F = 33.75, P<0.001). T1 self‑management scores were lower than T2 scores, and T1 CAT scores were higher than T2 CAT scores. Significant gender main effects were found (F = 14.65, P<0.001; F = 48.36, P<0.001). At both T1 and T2, female patients had higher CAT scores and lower self‑management scores than male patients. Time‑gender interaction effects were statistically significant (F = 8.46, P = 0.004; F = 7.80, P = 0.006). Females had higher CAT scores with larger magnitude of change and lower self‑management scores accompanied by larger magnitude of change. Cross‑lagged analysis showed that after controlling for gender, T1 quality of life positively predicted T2 self‑management ability (β=-0.180, P = 0.013), while T1 self‑management ability could not predict T2 quality of life (β=-0.107, P = 0.126). Conclusion Both quality of life and self‑management of elderly patients with COPD improved to some extent but remained suboptimal; special attention should be paid to female patients. Baseline quality of life can prospectively predict follow‑up self‑management ability. These are only observational temporal evidence rather than strict causal inference. Attaching importance to in‑hospital quality‑of‑life evaluation and delivering timely targeted interventions can help enhance patients’ post‑discharge self‑management ability.Trial registration: Not applicable.