Table 3.
Results of Delphi round 1 and 2
| Phase | Self-management behaviors rated in Delphi rounds | Behavior identified from (source) | Round 1 | Round 2 | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Relevancea | Improvementb | Feasibilityc | Relevancea | Improvementb | Feasibilityc | |||||||||
| M | IQR | M | IQR | M | IQR | M | IQR | M | IQR | M | IQR | |||
| 1. Stable (low risk) | Adherence to pharmacotherapy (LABA/LAMA and/or ICS)* | Literature | 8 | 3 | 8 | 1 | 7 | 2 | 8 | 0.75 | NA | NA | NA | NA |
| Influenza vaccination uptake* | Literature | 7 | 1.25 | 6 | 2.25 | 7 | 3 | NA | NA | 6 | 2 | 7 | 0.75 | |
| Daily physical activity* | Literature | 7 | 2.25 | 9 | 1 | 7 | 1.25 | 7 | 1.5 | NA | NA | NA | NA | |
| Avoiding viral or bacterial stimuli* | Literature | 7 | 2 | 7 | 2.25 | 6.5 | 2 | NA | NA | 7 | 0.75 | NA | NA | |
| Managing exposure to air quality** | Face validity | 7 | 2 | 6 | 1.5 | 5 | 1.25 | NA | NA | NA | NA | NA | NA | |
| Smoking cessation* | Literature | 8 | 2 | 8 | 2.25 | 7 | 3 | NA | NA | 8 | 0 | 7 | 1 | |
| Managing exposure to indoor air quality** | Delphi round 1 | NA | NA | NA | NA | NA | NA | 6 | 1.75 | 5 | 1.75 | 5.5 | 1 | |
| 2. Mild deterioration | Early detection of symptom deterioration* | Face validity | 8 | 1.25 | 8 | 0.5 | 7.5 | 1 | NA | NA | NA | NA | NA | NA |
| Correct increase of SABA** | Literature | 6 | 2 | 5.5 | 2.25 | 6 | 2.25 | NA | NA | 6 | 1 | 6 | 0.75 | |
| Performing breathing exercises** | Literature | 5.5 | 2.25 | 7 | 3 | 6.5 | 2 | 5 | 1 | 7 | 0.75 | NA | NA | |
| Performing energy conservation techniques** | Literature | 6 | 1.25 | 6 | 2 | 6 | 2.25 | NA | NA | NA | NA | 6 | 0.75 | |
| 3. Exacerbation | Early detection of an exacerbation* | Literature | 9 | 1 | 8 | 2 | 7 | 1 | NA | NA | NA | NA | NA | NA |
| Prompt treatment with corticosteroids and/or AB (self-treatment)* | Literature | 8.5 | 1 | 8 | 1.25 | 7 | 1.25 | NA | NA | NA | NA | NA | NA | |
| Prompt treatment with corticosteroids and/or AB (contacting HCP)* | Literature | 8.5 | 1 | 8 | 1.5 | 8 | 2.25 | NA | NA | NA | NA | 8 | 0 | |
| Manage stress and anxiety* | Literature | 7 | 1 | 7 | 0.5 | 6 | 2 | NA | NA | NA | NA | NA | NA | |
| Correct increase of SABA** | Literature | 6 | 3.5 | NA | NA | NA | NA | 6 | 1 | NA | NA | NA | NA | |
| Performing breathing exercises** | Literature | 6.5 | 2 | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | |
| Daily physical activity* | Literature | 7 | 3 | NA | NA | NA | NA | 7 | 1.75 | NA | NA | NA | NA | |
| Performing energy conservation techniques** | Literature | 6 | 2.25 | NA | NA | NA | NA | 6 | 1 | NA | NA | NA | NA | |
| 4. Recovery | Completing treatment with corticosteroids and/or AB* | Face validity | 7 | 1.25 | 6.5 | 2.25 | 7 | 1.25 | NA | NA | 6.5 | 1 | NA | NA |
| Manage stress and anxiety (concerning current event)* | Literature | 7 | 1.5 | 7 | 1.25 | 7 | 2.25 | NA | NA | NA | NA | 7 | 0.75 | |
| Adjusted exercise- and resistance training* | Literature | 7 | 1.25 | 8 | 2 | 7 | 1.25 | NA | NA | NA | NA | NA | NA | |
| Daily physical activity* | Literature | 8 | 1.5 | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | |
| Correct use of SABA** | Literature | 6.5 | 3 | NA | NA | NA | NA | 6 | 0.75 | NA | NA | NA | NA | |
| Performing energy conservation techniques** | Literature | 6 | 2 | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | |
| Performing breathing exercises** | Literature | 6 | 1.25 | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | |
| 5. Stable (at risk) | Increased awareness for recurring exacerbation* | Literature | 8 | 2 | 8 | 2 | 7.5 | 1.25 | NA | NA | NA | NA | NA | NA |
| Early (re)start of pulmonary rehabilitation* | Face validity | 8 | 2 | 8 | 2.25 | 7 | 2 | NA | NA | 8 | 0 | NA | NA | |
Notes:
Self-management behavior included in final list after round 1 or 2 based on median scores and consensus within the expert panel.
Self-management behavior excluded after round 1 or 2 based on median scores and consensus within the expert panel.
Relevance – The association of this behavior and reducing exacerbation impact (statement 1).
Improvement – The extent to whether there is room for improvement in this behavior (statement 2).
Feasibility – The feasibility to influence this behavior (statement 3). Scores are on a 9 point Likert scale (1= strongly disagree, 9= strongly agree); bold type indicates the returning self-management behaviors in which only statement 1 was rated and therefore scores on statements 2 and 3 are not applicable.
Abbreviations: NA, not applicable; M, median; IQR, interquartile range; AB, antibiotics; HCP, health care provider; LABA, long-acting β2-agonist; LAMA, long-acting muscarinic antagonist; ICS, inhaled corticosteroids; SABA, short-acting β2-agonist.