Effects of COPD self‐care management education at a nurse‐led primary health care clinic

Abstract

Chronic obstructive pulmonary disease (COPD) is disabling, with symptoms such as chronic cough, phlegm, wheezing, shortness of breath and increased infections of the respiratory passage. The aim was to examine the effects of a structured educational intervention programme at a nurse-led primary health care clinic (PHCC) on quality of life (QoL), knowledge about COPD and smoking cessation in patients with COPD. This study had an experimental design in which 52 patients with COPD from a Swedish primary care setting were randomized into two groups (intervention or control). Both groups received standard care but patients in the intervention group were also offered two visits to a nurse specialized in COPD care. The purpose of the visits was to increase the patients' self-care ability and their knowledge about COPD. The study was approved by the local Research Ethics Committee. Data were collected using two questionnaires, one pertaining to knowledge about COPD and smoking habits and St. George's Respiratory Questionnaire, addressing how QoL was affected by the patients' respiratory symptoms. The intervention and control groups answered both questionnaires on their first and last visits to the PHCC. A statistically significant increase was noted in the intervention group on QoL, the number of patients who stopped smoking and patients' knowledge about COPD at the follow-up, 3-5 months after intervention. However, a confounding factor may have been that one of the researchers (Eva Osterlund Efraimsson), as a nurse in the PHCC, performed the intervention. This implies that patients were in a dependent relationship which may have affected the responses in a favourable direction. Our findings show that conventional care alone did not have an effect on patients' QoL and smoking habits. Instead, the evidence suggests that a structured programme with self-care education is needed to motivate patients for life-style changes.

Programas educativos en pacientes con Enfermedad Pulmonar Obstructiva Crónica. Revisión integradora

“…Variables sociodemográficas (sexo y edad) (n=22) ( (49,75) , signos y síntomas (n=3) (5,47,53) , satisfacción (n=3) (53,63,75) , vacunación (n=1) (47) , adherencia terapéutica (n=1) (45) y evaluación de la técnica inhalatória (n=4) ( …”

“…En todos los estudios, salvo uno (64) , el modo de educación fue grupal, en algunos de los casos además se realizó de un plan individual (n=9) (45,46,48,55,60,64,71,73,74) , uso de folletos informativos para reforzar la educación (n=8) (5,45,48,53,54,60,67,71) , seguimiento telefónico (n=3) (45,70,71) o utilización de diario (n=3) (50,53,71) . El contenido de las sesiones educativas fue: en 18 artículos (81,8%) en sus sesiones educativas hablan sobre el conocimientos sobre la EPOC, con los siguientes componentes: anatomía y fisiología (n=3) (50,54,63) , descripción de la enfermedad (n=10) (5,(45)(46)(47)49,55,60,64,67,70) , signos y síntomas de la EPOC (n=3) (54,57,74) , signos y síntomas de las exacerbaciones (n=10) (50,54,55,57,60,63,64,…”

“…Otro de los apartados fue el tratamiento no farmacológico abordado en 19 estudios (86,4%), con los siguientes componentes: deshabituación tabáquica (n=15) (5,45,46,48,(53)(54)(55)57,60,(62)(63)(64)67,71,73) , práctica regular de ejercicio físico (n=9) (5,46,48,49,54,55,60,63,71) , hábitos nutricionales (n=10) (5,(46)(47)(48)(49)53,55,60,62,71) , control de las emociones (n=3) (49,55,71) , gestión de la disnea (n=3) (49,55,71) , técnicas de respiración (n=6) (45,47,55,63,70,71) , sueño y Artículos localizados con la estrategia "COPD "and "EDUCATION" N= 321…”

“…Artículos cuyo título y abstract hace referencia a programas de ET en paciente con EPOC N=58 descanso (n=4) (5,49,53,55) , limpieza de secreciones (n=1) (53) , sexualidad (n=1) (55) , higiene de manos (n=1) (63) , pérdida de peso (n=1) (48) y actividades ocio y viajes (n=1) (55) . En relación al tratamiento farmacológico era abortado en el 86,4% (n=19) de los estudios, específicamente en la instrucción en la técnica de inhalación (n=12) ( , oxigenoterapia (n=3) (47,55,64) y vacunación (n=3) (48,64,73) .…”

La educación terapéutica en los pacientes con EPOC

“…En todos los estudios, salvo uno (155) (207,208,210), satisfacción (154,210,222), vacunación (208), adherencia terapéutica (144) evaluación de la técnica inhalatoria (155,207,212,217) y el conocimiento de la EPOC (143,144,146,149,152,154,155,210).…”