Questionnaire Survey-Based Quantitative Assessment of the Impact of Transitional Care on Self-Management of Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Abstract

Background and Objective. Chronic obstructive pulmonary disease (COPD) features high morbidity. Different nursing interventions can relieve patient’s burden. This investigation quantitatively assessed the impact of transitional care (TC) on self-management of patients with acute exacerbation of COPD based on a questionnaire survey. Methods. Clinical information of 78 COPD patients treated with TC (intervention group) or routine care (control group) in Shanghai Pulmonary Hospital during March 2019 and August 2020 was gathered. Patients were followed up for 3 months after discharge. The intervention group ( n = 39 ) was subjected to a TC plan for 3 months to help patients and their family caregivers for self-management of COPD. TC was provided by specially trained nurses, and patients were supported by standardized tools. Nursing measures in the control group ( n = 79 ) included transitional support for 30 d after hospital discharge. In this way, patients were guaranteed to follow discharge plans and transit to outpatient nursing. Patient’s anxiety and depression symptoms, sleep quality, survival quality, mobility, and life quality at admission and after 3 months of discharge were assessed by Hospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index, Quality of Life Scale Abbreviated Version, Activity of Daily Life Scale, St. George’s Respiratory Questionnaire, and COPD Assessment Test. Results. Except for anxiety and depression, patient’s sleep quality, survival quality, mobility, and life quality in two groups were significantly improved. Moreover, average change of total CAT score during 3 months of intervention was -5.44, while that in the control group was -1.74 ( p = 0.011 ). Improvement of survival quality of patients in the intervention group ( p = 0.001 ) was markedly greater than that in the control group ( p = 0.016 ). Conclusion. Altogether, TC based on quantification by questionnaire survey is beneficial to COPD patient’s life quality and self-management.

Revisão de Literatura: Impacto das intervenções de enfermagem na taxa de reinternamento da pessoa com Doença Pulmonar Obstrutiva Crónica

“…Da avaliação efetuada, releva o facto da qualidade metodológica geral dos estudos ser relativamente alta, com pontuações superiores a 9 para a revisão sistemática e para os estudos randomizados. Nos estudos randomizados (13,14,15) , as inconformidades relacionaram-se com a falta de evidência de procedimentos de cegagem dos avaliadores e/ou dos participantes e com o facto de não haver referência acerca dos avaliadores dos resultados. Importa referir que para a avaliação da qualidade metodológica do estudo de Kargiannakis et al (14) , houve necessidade de identificar fontes de informação adicionais, nomeadamente o protocolo do estudo piloto para o ensaio clínico randomizado (16) , conforme sugerido pelos autores.…”

“…Effect of a Health Belief Model-based nursing intervention on Chinese patients with moderate to severe chronic obstructive pulmonary disease: a randomized controlled trial (13) 10/13 1c E5. Questionnaire Survey-Based Quantitative Assessment of the Impact of Transitional Care on Self-Management of Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease (15) 9/13 1c VOL. 7, Nº 1…”

“…( Dos cinco estudos selecionados para efeitos desta revisão, três foram realizados na China (13,15,17) , um na Nova Zelândia (18) e um no Reino Unido (14) .…”

Study Protocol for a Hospital-to-Home Transitional Care for Older Adults Hospitalized with Chronic Obstructive Pulmonary Disease in South Korea: A Randomized Controlled Trial

“…Previous studies have reported that, by providing TCS to COPD patients, their readmission and hospitalization periods decrease [9], and their dyspnea [9], quality of life [10], and depression scores [11] improved. Specifically, in the study by Ko et al [9], a respiratory nurse provided two hours of education on drug use, smoking cessation, and respiratory management to patients discharged from the hospital owing to exacerbation of COPD while a physical therapist performed pulmonary rehabilitation.…”

“…Consequently, the hospitalization period due to readmission, acute exacerbation, and the degree of dyspnea were reduced in the intervention group (IG). Similarly, in Xu's study [10], patients with COPD who were admitted to the hospital because of acute exacerbation were provided self-management education. After discharge, health guidance was provided via phone or messaging.…”