As part of a larger ongoing study of nurse-coached practice with dyspnea, 52 subjects (25 men, 27 women) with moderate to severe COPD exercised on a treadmill three times a week for 4 weeks. Subjects were randomized into a coached exercise group, which received nurse coaching during exercise, and a monitored exercise group, which exercised without instruction and encouragement in breathing and walking techniques. Self-efficacy (SE), the maximum treadmill level of speed and grade for which subjects had greatest confidence in ability to walk for 5 minutes, was assessed before each session. Performance (PERF) was the maximum treadmill level actually achieved for 5 minutes. While both self-efficacy and performance increased significantly across the 12 sessions for the total sample (p < 0.001), SE was significantly lower than PERF (p < 0.0005). SE was correlated with PERF at all sessions (p < 0.005). SE and PERF became more congruent over time, although 44% of the sample (n = 23) continued to underestimate ability to walk relative to actual performance at session 12. The most common patterns of change in SE and PERF for individuals across the 12 sessions were increased congruency (n = 24) and consistent underestimation (n = 13). Women had a significantly greater improvement in SE across the 12 sessions than men (p < 0.05).
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