Hassanein Salwa E, Narsavage Georgia L, Williams Sherrie Dixon, Anthony Mary K, Gittner Lisaann S
Perm J. 2007 Fall;11(4):50-3. doi: 10.7812/TPP/07-010.
Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the United States, and millions of COPD patients are disabled and unable to work. Pulmonary rehabilitation (PR) programs are available to assist with disability, but it is not clear who is likely to consistently participate in them. The purpose of this study was to determine which participants were likely to consistently attend a PR program.
A retrospective medical record review was used to assess 104 community-dwelling adults with COPD who completed the PR program at a Midwest medical center between 2000 and 2005.
The sample consisted of 32 men and 72 women with a mean age of 59.9 years (±19.10 years), mean predicted one-second forced expiratory volume (FEV(1)) of 46.45% (SD = 20.1), mean percent forced vital capacity (FVC%) of 67.61 (SD = 16.61), mean FEV(1)/FVC% ratio of 51.15% (SD = 18.17), and mean residual volume (RV) of 150.66% (SD = 67.01).
Contextual variables of current smoking (beta = -.36), male sex (beta = .19), not having emphysema (beta = -.27), and FVC% (beta = .32) were significant predictors of attendance at (a dose of) PR. The number of selected comorbidities significantly predicted the dose of PR (beta = -.20).
These findings support the ability to identify factors that predict attendance at a PR program. Nurses can assess patients at risk for lack of consistent PR attendance and implement interventions to improve attendance. Specifically, smoking cessation prior to or as an integral part of PR programs may improve attendance.
慢性阻塞性肺疾病(COPD)是美国第四大死因,数百万COPD患者致残且无法工作。肺康复(PR)项目可帮助改善残疾状况,但尚不清楚哪些人可能持续参与这些项目。本研究的目的是确定哪些参与者可能持续参加PR项目。
采用回顾性病历审查,评估2000年至2005年间在中西部医疗中心完成PR项目的104名社区居住的成年COPD患者。
样本包括32名男性和72名女性,平均年龄59.9岁(±19.10岁),预计1秒用力呼气容积(FEV₁)平均值为46.45%(标准差=20.1),用力肺活量百分比(FVC%)平均值为67.61(标准差=16.61),FEV₁/FVC%比值平均值为51.15%(标准差=18.17),残气量(RV)平均值为150.66%(标准差=67.01)。
当前吸烟(β=-0.36)、男性(β=0.19)、无肺气肿(β=-0.27)和FVC%(β=0.32)等背景变量是参加(一定剂量)PR的显著预测因素。所选合并症的数量显著预测了PR的剂量(β=-0.20)。
这些发现支持识别预测参加PR项目的因素的能力。护士可以评估有持续参加PR项目风险的患者,并实施干预措施以提高参与率。具体而言,在PR项目之前戒烟或作为PR项目的一个组成部分可能会提高参与率。