Wang Lian Hong, Zhao Yan, Chen Ling Yun, Zhang Li, Zhang Yong Mei
Nursing department of Affiliated Hospital of Zunyi Medical University, ZunYi, China.
Nursing department of ZunYi Medical University, ZunYi, China.
Clin Respir J. 2020 Feb;14(2):148-157. doi: 10.1111/crj.13112. Epub 2019 Dec 12.
To examine the effectiveness of a nurse-led self-management program on outcomes of patients with chronic obstructive pulmonary disease (COPD).
A randomized controlled, single-blind trial, carried out from October 2017 to December 2018, included 154 participants admitted with COPD to the Affiliated Hospital of Zunyi Medical University in Guizhou, (randomized into intervention (n = 77) and control groups (n = 77)).
Participants in the intervention group underwent a nurse-led self-management program in addition to routine care, and participants of the control group received only routine care. The main outcome measures were COPD-related readmission and emergency department visits, the 6-minute walk distance (6MWD) test for measurement of exercise capacity, the St George Respiratory Questionnaire (SGRQ) for measurement of health-related quality of life, and the COPD Transitional Care Patient Satisfaction Questionnaire (CTCPSQ) for measurement of satisfaction. Data collection was conducted at baseline (T1) and after 3 (T2), 6 (T3) and 12 mo (T4). Findings Compared to the control group, participants in the intervention group showed significantly fewer COPD-related hospital admissions (P = 0.03) and emergency department visits (P = 0.001) and higher total CTCPSQ scores (P = 0.001) at 12 mo. Meanwhile, analysis of variance showed a significantly greater improvement in exercise capacity and health status over time in the nurse-led program group than in the control group, P < 0.001.
This study demonstrated that the nurse-led self-management program was effective in decreasing hospital readmissions and emergency department visits and improving exercise capacity, health-related quality of life and satisfaction for patients with COPD.
探讨护士主导的自我管理项目对慢性阻塞性肺疾病（COPD）患者预后的有效性。
一项随机对照单盲试验，于2017年10月至2018年12月进行，纳入154例因COPD入住贵州遵义医科大学附属医院的患者（随机分为干预组（n = 77）和对照组（n = 77））。
干预组患者除接受常规护理外，还接受护士主导的自我管理项目，对照组患者仅接受常规护理。主要结局指标包括与COPD相关的再入院和急诊就诊情况、用于测量运动能力的6分钟步行距离（6MWD）测试、用于测量健康相关生活质量的圣乔治呼吸问卷（SGRQ）以及用于测量满意度的COPD过渡护理患者满意度问卷（CTCPSQ）。在基线（T1）以及3个月（T2）、6个月（T3）和12个月（T4）后进行数据收集。结果与对照组相比，干预组患者在12个月时与COPD相关的住院次数（P = 0.03）和急诊就诊次数显著减少（P = 0.001），CTCPSQ总分更高（P = 0.001）。同时，方差分析显示，与对照组相比，护士主导项目组的运动能力和健康状况随时间有显著更大的改善，P < 0.001。
本研究表明，护士主导的自我管理项目在减少COPD患者的再入院和急诊就诊次数以及改善运动能力、健康相关生活质量和满意度方面是有效的。
