The Effectiveness of Nurse-Led, Home-Based Pulmonary Rehabilitation in Patients with COPD in Turkey

Abstract

The goal of this study was to determine the effectiveness of nurse-led, home-based pulmonary rehabilitation in patients with stage 3 or 4 chronic obstructive pulmonary disease (COPD), according to the Global Initiative for COPD (GOLD) staging system. The study consisted of 32 patients--a nurse-led, home-based pulmonary rehabilitation group (16) and a control group (16). In the rehabilitation program, patients received education about their diseases and performed breathing exercises and lower- and upper-extremity aerobic exercises at their homes during the 3-month period of the study. There was meaningful improvement in the rehabilitation group in terms of pulmonary function tests (FEV1 % predicted value), artery blood gases (PaCO2), quality of life, dyspnea, and functional capacity. On the other hand, no meaningful change was observed in the control group. The study showed that the nurse-led, home-based pulmonary rehabilitation program had positive effects on the patients with COPD.

Home or community-based pulmonary rehabilitation for individuals with chronic obstructive pulmonary disease: a systematic review and meta-analysis

“…Of these, 58 were considered potentially relevant and 23 studies 17,18,19,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50 met the eligibility criteria and were included in this review. One of the selected studies appeared in two distinct publications 49,50 in which the same intervention was applied to the same patients but describing different outcomes.…”

“…Thirteen studies were done in Europe 17,19,21,31,33,38,42,43,45,46,48,49,50 , six in Asia 30,36,39,40,44,47 , two in Australasia 34,35 , one in North America 41 , and one in South America 32 . Among the studies included in the review, 19 17,18,19,30,31,32,33,34,36,38,39,40,42,43,44,46,47,48,49,50 compared HCPR to control group (n = total 893; n HCPR = 485), while four 35,37,41,45 compared HCPR to OPR (n total = 375; n HCPR = 178). No studies reported harmful effects related to HCPR during interventions.…”

“…• Analysis 1: HCPR vs. control group (a) Functional Capacity and Dyspnea: Ten studies 30,31,33,36,40,44,46,47,48,50 (n = 461) assessed functional capacity with the 6MWT and seven used the ISWT 18,32,34,38,39,42,43 (n = 321). Four studies 19,38,43,48 (n = 280) evaluated dyspnea using the MRC.…”

“…Finally, there was a significant decrease in sensation of dyspnea assessed by MRC in HCPR compared to controls (-0.21, 95%CI: -0.42 to -0.00, I 2 = 0%) ( Figure 6). (b) Quality of Life: Thirteen studies 17,18,19,31,33,34,36,38,42,44,46,47,49 (n = 521) assessed quality of life with CRQ and four 18,30,39,48 (n = 281) with SGRQ. The meta-analysis showed that participants who received the intervention showed significant improvement in the four quality of life domains as- Figure 3 Graph on risk of bias for each selected study.…”

Nurses' decision-making in ethically relevant clinical situations using the example of breathlessness: study protocol of a reflexive grounded theory integrating Goffman's framework analysis

“…Nurses' treatment options and decision-making (DM) in severe breathlessness As seen in studies on the implementation of interventions [10][11][12][13] or in guidelines recommending interventions, 14 15 nurses' treatment options in breathlessness vary in different countries and settings, as do the duties and legal responsibility they have. Other issues include a lack of institutional support for specialised nurses, too little time and few possibilities for systematic reflection or supervision.…”