The Relationship Between Dyspnea and Fatigue and Levels of Medication Adherence and Self-Efficacy in Individuals with Chronic Obstructive Pulmonary Disease

Abstract

Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disease marked by symptoms such as dyspnea and fatigue, which negatively affect patients' quality of life. Self-efficacy influences patients' ability to manage symptoms, while medication adherence is crucial for effective disease control. This study aimed to examine the impact of dyspnea and fatigue on medication adherence and self-efficacy in individuals with COPD. A descriptive, cross-sectional, and correlational study was conducted with 171 COPD patients receiving treatment in a tertiary hospital in eastern Turkiye between November 2024 and April 2025. Data were collected using validated scales measuring fatigue, dyspnea, medication adherence, and self-efficacy. Statistical analyses included correlation and regression to examine relationships and predictors. The findings revealed high levels of dyspnea and fatigue, which were significantly and negatively correlated with self-efficacy (p < .001). Both dyspnea and fatigue significantly predicted decreased self-efficacy, accounting for over 60% of the variance. Medication adherence levels were generally high; medication adherence decreased when dyspnea increased, while no relationship was observed between fatigue and medication adherence. Dyspnea and fatigue are prevalent symptoms in COPD patients that adversely affect self-efficacy. Enhancing self-efficacy may be critical in improving symptom management and quality of life. The complex nature of medication adherence requires further in-depth investigation. Nurses should prioritize interventions that strengthen self-efficacy and address symptom burden to optimize COPD management and patient outcomes.