Effects of Promoting Health Literacy Program toward Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease Patients
Keywords:
promoting health literacy program, pulmonary rehabilitation, chronic obstructive pulmonary disease patientsAbstract
This quasi-experimental study examined the effects of a health literacy enhancement program on pulmonary rehabilitation among COPD patients at Phoprathapchang Hospital, Phichit Province. The sample consisted of 50 COPD patients receiving treatment at the hospital’s COPD clinic, divided equally into experimental group (n=25) and control group (n=25). Participants were randomly assigned to each group using simple random sampling by drawing lots without replacement. The experimental group participated in a health literacy enhancement program for COPD patients, which had been validated with IOC of 1.00, while the control group received routine nursing care. Research instruments included a health literacy scale (IOC=0.94, reliability=0.93) and a clinical data record form for pulmonary function parameters: FEV1/FVC ratio, 6MWD, and mMRC.
The results revealed that the experimental group showed significantly higher mean scores in health literacy, FEV1/FVC, and 6MWD, while the mMRC scores decreased significantly after participation in the program (p < .01). Moreover, post-intervention comparisons indicated that the experimental group had significantly greater improvements in health literacy, FEV₁/FVC, and 6MWD, and lower mMRC scores than the control group (p < .01). These findings demonstrate that the health literacy enhancement program effectively improved both health literacy and pulmonary function among COPD patients. The program can be integrated into COPD clinics at Sub-district Health Promoting Hospitals or other healthcare facilities and extended to the general population to promote self-care and prevent COPD.
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References
Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. Geneva: GOLD,2023.
Thoracic Society of Thailand under Royal Patronage. Thai COPD Guideline 2022. Bangkok: Thoracic Society of Thailand under Royal Patronage, 2022.
HISO.ThaiHealthStat. [Cited 2025 April 2] Available from: https://www.hiso.or.th/thaihealthstat/area/index.php?ma=1&pf=01818101&tp=12_6
Zhang H., Hu D., Xu Y., Wu L., & Lou L. Effect of pulmonary rehabilitation in patients
with chronic obstructive pulmonary disease: a systematic review and meta-analysis of
randomized controlled trials. Ann Med. 2022; 54(1), 262-273
MIS. CD-NCD Data 2025. [Cited 2025 March 11] Available from:
https://www.ppho.go.th/mis-new/index.php?menu=5.9
Srinual P., Kompayak J., & Buajaroen H. Effects of Pulmonary Rehabilitation Program To Prevent Exacerbation in Patient With Chronic Obstructive Pulmonary Disease In
Community. Journal of The Royal Thai Army Nurses, 2019; 20(2), 351-359. (in Thai)
Qin H. et al. Barriers and facilitators to pulmonary rehabilitation in COPD: a mixed-
methods systematic review. BMC Pulm Med. 2025; 25(1), 314.
Pongkiew P., Narin R., & Tuanrat W. Effects of a Family Empowerment Program on
Pulmonary Rehabilitation Practices for Persons with Chronic Obstructive Pulmonary
Disease at Home. Lanna Public Health Journal, 2023; 19(1), 89-101. (in Thai)
Nutbeam D. The evolving concept of health literacy. Social Science & Medicine,
; 67(12), 2072-2078.
Azkan T.D., Bhattacharya S., Demirci H., & Yildiz T. Health Literacy and Health Outcomes in Chronic Obstructive Pulmonary Disease Patients: An Explorative Study. Front Public Health, 2022; 10, 846768.
Puente-Maestu L. et al. Health literacy and health outcomes in chronic obstructive pulmonary disease. Respir Med, 2016; 115, 78-82.
Limrermsakul S., Saneha C., Wattanakitkrileart D., & Buranasupkajorn P. Effects of a Health Literacy Development Program on Self-care Behaviors in Elderly with Type 2Diabetes Mellitus. Nursing Science Journal of Thailand, 2021; 40(1): 84-98. (in Thai)
Donchai J., Panuthai S., & Tamdee D. Effect of PITS-based Education to Enhance Health Literacy on Self-Management Among Older Persons with Chronic Obstructive Pulmonary Disease. Nursing Journal CMU, 2024; 51(1): 98-113. (in Thai)
Sutthiviriwan S. Nursing challenges in caring for patients with chronic obstructive
pulmonary disease: the next normal. J Nurs Sci Health, 2024; 47(3): 15-25. (in Thai)
Edmonds WA, Kennedy TD. An Applied Reference Guide to Research Designs:
Quantitative, Qualitative, and Mixed Methods. California: SAGE, 2017.
Wiratchai N. estimation of sample size. 2012. [cited 2025 June 28]. Retrieved from
https://lllskill.com/web/files/GPower.pdf (in Thai)
Rungcharoenareejit M. The Effect of the Health Literacy Program on Uncontrolled Type 2 Diabetes Mellitus Patients, Ban Haeng Tai Health Promoting Hospital, Ngao District, Lampang Province. Primary Health Care Journal (Northern Edition), 2024; 34(2): 46-53. (in Thai)
Mathew H., Thanabadu S., & Trivedy, C. Get Through MCEM Part B: Data Interpretation
Questions. Florida: CRC Press, 2017.
Poh H., Eastwood P.R., Cecins N.M., Ho K.T., & Jenkins S.C. Six-minute walk distance in
healthy Singaporean adults cannot be predicted using reference equations derived from Caucasian populations. Respirology, 2006; 11: 211-216.
Mahler D.A., & Wells C.K. Evaluation of clinical methods for rating dyspnea. Chest, 1988; 93: 580-586.
Bandura, A. Self-efficacy: The exercise of control. New York: W. H. Freeman, 1997.
Sørensen K. et al. Health literacy and public health: A systematic review and integration of definitions and models. BMC Public Health, 2012; 12(80): 1-13.
Paasche-Orlow M.K., & Wolf M.S. The causal pathways linking health literacy to health
outcomes. American Journal of Health Behavior, 2007; 31(Suppl 1); S19-S26.
Shahi M.H.P. et al. Effects of Pulmonary Rehabilitation Program on Patients With Chronic Obstructive Pulmonary Disease. Journal of Modern Rehabilitation, 2022; 16(1): 23-30.
Zhou Y., Chen R., & Liang Z. Effects of health education combined with exercise training on pulmonary function and quality of life in patients with COPD. International Journal of Chronic Obstructive Pulmonary Disease, 2021; 16: 1503-1512.
Salim et al. Health literacy levels and its determinants among people with asthma in
Malaysian primary healthcare settings: a cross sectional study. BMC Public Health, 2021; 21: 1186, 2-11.
Lorig K.R., & Holman H.R. Self-management education: History, definition, outcomes, and mechanisms. Annals of Behavioral Medicine, 2003; 26(1): 1-7.
Panmuangkook N., Wongken Y., & Defossez K. The Development of Nursing Service
Practice Guidelines to Promote Self-Management of Patients with COPD Clinic. Journal of Environmental and Community Health, 2024; 9(2): 98-108. (in Thai)
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