A new pulmonary rehabilitation maintenance strategy through home-visiting and phone contact in COPD

Li, Yang; Feng, Jing; Li, Yuechuan; Jia, Wei Hua; Qian, Hongyan

doi:10.2147/ppa.s150679

Cited by 21 publications

(23 citation statements)

References 35 publications

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“…Previous PR programs in COPD have reported an increase in functional capacity, decrease in symptom burden, reduced care dependency, and improvement in the quality of life. 25-30 On the contrary, it is important to note that few of these programs have been conducted by nurses. 31,32 Further nursing-driven programs are urgently needed because of high symptom burden, polypharmacy, repeated hospitalizations and high care dependency in patients with COPD.…”

Section: Introductionmentioning

confidence: 99%

The Effects of a Nurse-Led Education and Counseling Program on Dyspnea, Health Status, and Care Dependency in Patients With Chronic Obstructive Pulmonary Disease: A Feasibility Study

Helvaci

Metin

Özdemir

et al. 2019

Home Health Care Management & Practice

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The aim of this feasibility study was to determine the effects of a nurse-led education and counseling program for chronic obstructive pulmonary disease (COPD-ECP) on dyspnea, health status, and care dependency in patients. A quasi-experimental, pre-posttest research design without a control group was performed on 30 COPD patients. The patients received an 8-week COPD-ECP via home visits during the first 4 weeks and via phone interviews in the subsequent 4 weeks. After completion of COPD-ECP and a 4-week break, a final follow-up was conducted at the end of 12th week. The Dyspnea-12, COPD Assessment Test (CAT), and Care Dependency Scale (CDS) scores were calculated during the first interview, and on the 4th, 8th, and 12th week of the study. The patients completed all sessions of COPD-ECP without side effects. There was a significant decrease in the total Dyspnea-12 scores at the end of the study period. Compared to the baseline assessment, CAT total scores significantly decreased in the 4th, 8th, and 12th week ( p < 0.05), and CDS scores showed a significant reduction at the 12th week ( p < 0.05). In conclusion, COPD-ECP is feasible in regular clinical practice and well accepted by patients, and it seems to improve health status and decrease dyspnea, and care dependency. Future randomized controlled studies are warranted to explore the effects of COPD-ECP on fatigue, cough and sleep problems, and the best innovative strategies to improve the efficiency of COPD-ECP.

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Section: Introductionmentioning

confidence: 99%

The Effects of a Nurse-Led Education and Counseling Program on Dyspnea, Health Status, and Care Dependency in Patients With Chronic Obstructive Pulmonary Disease: A Feasibility Study

Helvaci

Metin

Özdemir

et al. 2019

Home Health Care Management & Practice

View full text Add to dashboard Cite

show abstract

“…Previous studies in persons with COPD who had not already engaged in pulmonary rehabilitation support TC's feasibility, safety and efficacy [ 35 , 36 ]. The low-impact, adaptable movements and postures make TC particularly attractive for persons with COPD [ 37 , 38 ]. In a separate pilot randomised controlled trial (RCT) in patients with moderate–severe COPD, we demonstrated trends toward improvement in HRQL, depression and dyspnoea after 3 months of TC versus an education control group [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Long-term Exercise After Pulmonary Rehabilitation (LEAP): a pilot randomised controlled trial of Tai Chi in COPD

et al. 2021

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Mind-body modalities are promising strategies to maintain the benefits gained after completion of conventional pulmonary rehabilitation (PR) in persons with COPD.In this pilot randomised controlled study, we examined Tai Chi in persons with COPD after completing PR. Participants were randomised 2:2:1 to Tai Chi (TC), usual care (UC), or group walking (GW) for 24 weeks. We assessed feasibility; primary outcome was exercise capacity measured by 6-min walk test (6 MWT) distance at 24 weeks. Secondary outcomes included health-related quality of life measured by Chronic Respiratory Questionnaire (CRQ), dyspnea, mood, stress, social support, self-efficacy, physical activity, and exercise engagement. Effect size estimates and estimates from generalised estimating equations were calculated.Ninety-one persons (36 TC, 37 UC, 18 GW) were enrolled, with age 69±6 years, 59% male, and FEV1% predicted 48±19. There was no difference in adherence and adverse events between groups. There was a small between-group effect size (ES=0.25) in change in 6 MWT distance favoring TC compared to UC; 24-week comparison was nonsignificant (p=0.10). There were no differences in secondary outcomes. In exploratory analyses, there was a greater percentage of participants in TC who improved 6 MWT distance at 24 weeks, compared to UC, 64% versus 39%, p=0.05. There were higher percentages of participants in TC who improved CRQ Fatigue (59% versus 31%, p=0.02) and CRQ Mastery (47% versus 20%, p=0.01) domain scores, compared to UC. For GW, there were no differences compared with TC.Tai Chi may be a feasible option to maintain the benefits gained after completing conventional PR.

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“…One of the subcategories of this category was patients’ limited access to PR services. Home visit for improving home environment and providing correct home-based services is a key component of PR for patients with COPD [ 42 ]. However, home visit is not performed in many developing countries, like Iran, resulting in patients’ limited access to some PR services and reduced effectiveness of PR [ 43 ].…”

Section: Discussionmentioning

confidence: 99%

Exploring the barriers to pulmonary rehabilitation for patients with chronic obstructive pulmonary disease: a qualitative study

Sami

Salehi

Hashemi

et al. 2021

BMC Health Serv Res

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Background The complexity of chronic obstructive pulmonary disease (COPD) and its different physical, mental, familial, occupational, and social complications highlight the necessity of pulmonary rehabilitation (PR) for afflicted patients. However, PR for patients with COPD usually faces some barriers. The aim of this study was to explore the barriers to PR for patients with COPD. Methods This qualitative descriptive study was conducted in January 2019 to October 2020. Participants were 19 patients with COPD, 11 family caregivers of patients with COPD, and 12 healthcare providers, who all were recruited purposively from two teaching hospitals in Isfahan, Iran. Data were collected through semi-structured interviews and were analyzed through conventional content analysis. Results The barriers to PR for patients with COPD fell into three main categories, namely barriers related to patients and their families, inefficiency of PR services, and inappropriate organizational context for PR. Each category had four subcategories, namely patients’ and families’ lack of knowledge, complexity and chronicity of COPD, heavy financial burden of COPD, patients’ frustration and discontinuation of PR, lack of patient-centeredness, lack of coordination in PR team, inadequate professional competence of PR staff, lack of a holistic approach to PR, limited access to PR services, inadequate insurance for PR services, ineffective PR planning, and discontinuity of care. Conclusion PR for patients with COPD is a complex process which faces different personal, familial, social, financial, organizational, and governmental barriers. Strategies for managing these barriers are needed in order to improve the effectiveness and the quality of PR services for patients with COPD.

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A new pulmonary rehabilitation maintenance strategy through home-visiting and phone contact in COPD

Cited by 21 publications

References 35 publications

The Effects of a Nurse-Led Education and Counseling Program on Dyspnea, Health Status, and Care Dependency in Patients With Chronic Obstructive Pulmonary Disease: A Feasibility Study

The Effects of a Nurse-Led Education and Counseling Program on Dyspnea, Health Status, and Care Dependency in Patients With Chronic Obstructive Pulmonary Disease: A Feasibility Study

Long-term Exercise After Pulmonary Rehabilitation (LEAP): a pilot randomised controlled trial of Tai Chi in COPD

Exploring the barriers to pulmonary rehabilitation for patients with chronic obstructive pulmonary disease: a qualitative study

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