Abstract
BACKGROUND: Effective self-management is crucial for Chronic Obstructive Pulmonary Disease (COPD) patients, yet significant heterogeneity exists in their self-management behaviors. Understanding this variation is key to providing personalized care. This study aimed to identify distinct latent classes of self-management behaviors among COPD patients and explore the factors associated with class membership. METHODS: A cross-sectional survey was conducted with 315 COPD inpatients from a tertiary hospital in Hebei, China. Data were collected using the COPD Self-Management Scale, the modified Medical Research Council Dyspnea Scale (mMRC), the Fatigue Severity Scale (FSS), the Hospital Anxiety and Depression Scale (HADS), and a sociodemographic/clinical questionnaire. Latent Class Analysis (LCA) was used to identify unobserved subgroups based on self-management patterns. Factors influencing class membership were identified using multivariate logistic regression analysis. RESULTS: LCA revealed three distinct latent classes of self-management: “Comprehensive Weakness” (45.4%), characterized by poor performance across all domains; “Symptom-Disconnected” (35.9%), showing adequate symptom management but poor daily life/emotion management; and ‘Balanced Management” (18.7%), demonstrating strong performance in all areas. Multivariate analysis indicated that higher education level, longer disease duration, and higher social support were significant predictors of belonging to the “Balanced Management” class compared to the “Comprehensive Weakness” class. Anxiety was a significant negative factor distinguishing the classes. CONCLUSIONS: This study identifies three distinct profiles of self-management behavior in COPD patients, highlighting the need for tailored interventions rather than a one-size-fits-all approach. Factors such as education, disease duration, and social support are key determinants of better self-management. Clinicians should prioritize assessing and addressing anxiety and leverage social support to help patients transition towards more balanced and effective self-management practices. TRIAL REGISTRATION: Not applicable. This study is an observational, cross-sectional survey and does not involve a health care intervention. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12890-025-04074-1.