The Impact of Training on Self-Efficacy, Symptom Level, and Activities of Daily Living

Self Efficacy

The COPD Self-Efficacy Scale is a 5-point Likert-type instrument consisting of 34 items and five subscales that assess patients' confidence in managing or avoiding dyspnea during specific activities. The five subscales are negative affect, emotional arousal, physical exertion, weather/environmental factors, and behavioral risk factors. The negative affect subscale measures confidence in managing dyspnea in stressful situations. The emotional arousal subscale assesses confidence in coping with dyspnea during emotional distress such as anger, fear, and life-related stress. The physical exertion subscale evaluates confidence in managing dyspnea during situations that may provoke breathlessness, such as rapid stair climbing or cold weather exposure. The behavioral risk factors subscale measures behaviors related to non-adherence to diet and treatment and dyspnea-related behaviors. Higher scores indicate greater confidence in managing or avoiding dyspnea. Total scores range from 34 to 170.

Symptom Level

The COPD Assessment Test (CAT) is an instrument used to assess the impact of COPD symptoms, including dyspnea, cough, sputum production, fatigue, and activity limitations, on daily life and overall health status. The CAT consists of 8 items and is simple and quick to administer. Each item is scored on a 5-point scale, with total scores ranging from 0 to 40. Higher scores indicate a greater impact of COPD symptoms and increased severity of dyspnea. Scores are categorized as low (0-10), moderate (11-20), high (21-30), and very high impact (31-40). The CAT is a reliable and valid tool widely used in clinical practice.

Daily Living Activities

The London Chest Activity of Daily Living Scale is a simple questionnaire developed to assess dyspnea related to daily living activities in patients with COPD. It consists of 15 items across four domains: personal care (4 items: drying, dressing the upper body, putting on shoes/socks, washing hair), domestic activities (6 items: making the bed, changing sheets, washing windows/curtains, cleaning/dusting, washing dishes, vacuuming), physical activity (2 items: climbing stairs, bending), and leisure activities (3 items: walking indoors, going out socially, talking). The maximum possible score is 75. Higher scores indicate greater limitation in performing daily activities, whereas lower scores reflect higher activity levels.