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. 2015 Sep 15;8(9):15878-88.
eCollection 2015.

A new mode of community continuing care service for COPD patients in China: participation of respiratory nurse specialists

Pingdong Li  1 , Yucui Gong  1 , Guangqiao Zeng  2 , Liang Ruan  1 , Guifen Li  1
Affiliations

A new mode of community continuing care service for COPD patients in China: participation of respiratory nurse specialists

Pingdong Li et al. Int J Clin Exp Med. .

Abstract

Objective: This study explored a community nursing service mode in which respiratory nurse specialists cared for patients with chronic obstructive pulmonary disease (COPD) in a 12-week period after hospital discharge, with the aim of better preventing acute exacerbations, improving health-related quality of life (HRQOL) and reducing medical expenses in these patients.

Methods: We carried out a prospective randomized controlled study in which 68 COPD patients discharged were recruited from a general hospital in Guangzhou, China, were randomized divided into two groups. The control group underwent conventional nursing care, and the intervention group received community continuing care by respiratory nurse specialists. The observation period was 12 weeks. The results of intervention were evaluated using the Seattle Obstructive Lung Disease Questionnaire (SOLDQ) and the COPD Self-Efficacy Scale (CSES). In addition, the frequency of acute exacerbations, emergency treatments or hospitalizations, and medical expenses were recorded in the 12-week observation period.

Results: After six weeks, the total and subscale scores (P < 0.05) of SOLDQ and CSES significantly improved compared to the baseline ones in the intervention group. The control group had significantly higher scores in the treatment satisfaction (TS) of SOLDQ, the total score, and the weather/environment and behavioral risk factors of CSES. After 12 weeks, the total and subscale scores of SOLDQ and CSES showed a sustained and significant growth in the intervention group (P < 0.05). The control group had significantly higher scores only in the weather/environment risk factor of CSES. During the 12-week observation, the intervention group had significantly fewer acute exacerbations, emergency treatments or re-hospitalizations and significantly lower average medical expenses than the control group (P < 0.05).

Conclusions: Community continuing care by respiratory nurse specialists may improve HRQOL, increase self-efficacy, reduce incidence of acute exacerbation, and lower medical expenses in patients with COPD after hospital discharge.

Keywords: Community continuing care; chronic obstructive pulmonary disease; health-related quality of life (HRQOL); respiratory nurse specialists.

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Figures

Figure 1
Figure 1
The flow diagram for this study SOLDQ, Seattle Obstructive Lung Disease Questionnaire CSES, COPD Self-Efficacy Scale.
Figure 2
Figure 2
A: Comparing the mean total score of SOLDQ pretest, 6 weeks and 12 weeks after discharge. B: Comparing the mean dimension score of SOLDQ pretest, 6 weeks and 12 weeks after discharge.
See this image and copyright information in PMC

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