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Nonadherence to health promotion depending on chronic obstructive pulmonary disease severity

      Highlights

      • The current national diagnostic rate and awareness for early diagnosis and treatment for COPD is still low.
      • COPD patients with more stress and comorbidities are more likely to show nonadherence to health behaviors.
      • Nonadherence to health behaviors is higher in moderate and severe COPD groups than in the mild COPD group, so it is necessary to tailor healthcare steps to the severity of the disease.

      Abstract

      Background

      Nonadherence to recommended health behaviors reportedly correlates with the prevalence and health outcomes of COPD, but the factors contributing to multiple health promotions are not well understood.

      Objective

      To examine the factors associated with nonadherence to health behaviors, specifically focusing on COPD severity.

      Methods

      We conducted a secondary data analysis with data from the 2016–2019 Korea National Health and Nutrition Examination Survey. The analyzed data were from 1,627 individuals aged over 40 years who had a FEV1/FVC ratio < 70% measured via spirometer. In this study, nonadherence to health behaviors is the sum of seven health-promoting behaviors in terms of smoking cessation, alcohol abstinence, regular exercise, weight control, recommended sleep time, influenza vaccination, and medical check-up.

      Results

      COPD patients’ nonadherence to health behaviors was significantly associated with comorbidity (p=0.017), stress (p=0.002), and COPD severity (moderate, severe; p=0.010, p=0.039, respectively). In addition, the moderate and severe COPD groups showed a higher nonadherence rate than the mild COPD group. Specifically, nonadherence to weight control was the most significantly different behavior according to COPD severity levels, based on the GOLD classification of airflow limitation.

      Conclusion

      Our study findings support that those with higher levels of stress, comorbidities, and severe disease conditions are less likely to adhere to health behaviors. Thus, healthcare providers and policymakers should provide tailored approaches according to COPD severity to educate and support appropriate health behaviors for individuals with COPD.

      Keywords

      Abbreviations:

      COPD (Chronic obstructive pulmonary disease), KNHANES (Korea National Health and Nutrition Examination Survey), GOLD (Global Initiative for Chronic Obstructive Lung Disease)
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