The vision of older COPD patients with different knowledge and motivations:a qualitative study to understand the barriers and recommendations to improving self-management

Objective: To explore opportunities for improving care based on the experiences and perspectives of different types of COPD patients based on the Information-Motivation-Behavioral skills (IMB) model with poor self-management behaviors . Methods: We used ethnographic methods(over 1000 hours of observations for 30 participants), and conducted 34 semi-structured interviews with different types of COPD patients. Data were analysed using inductive thematic analysis. Results: According to the IMB model, we divide participants into three categories, namely low-information and low motivation group, high information but low motivation group and low- information but strong motivation group. In the first group, due to the single source of information and decreased memory capacity. Also, patients showed a low perceived threat of disease and negation of self-management value, which led to the lack of self-management knowledge and motivation for this group of patients. In the second group, patients were pessimistic about the cure of the disease because of too much information or too much attention to the details of knowledge, which was also the reason why patients were unwilling to implement the self-management although they had mastered enough knowledge. The third type of patients, with strong motivation, would seek health information resources through various channels. Because of this, they could easily catch incorrect or unscientific information, which would make the situation worse. Conclusion: This qualitative study suggest COPD patients exhibit distinct self-management experiences, barriers, and recommendations due to variations in information processing and motivational characteristics. Future research should tailor precise self-management strategies based on individual patient profiles.