Effects of specialized community nursing care in patients with chronic obstructive pulmonary disease.
OBJECTIVE
To investigate the effects of specialized respiratory home nursing care after discharge from a pulmonary rehabilitation center.


METHODS
Pretest-posttest control group design. Patients in the experimental group were visited by a nurse who specializes in respiratory care, whereas the control group received care from nurses who did not specialize in respiratory care.


METHODS
Data were collected on admission, at program discharge, and 4 months and 9 months after discharge from a pulmonary rehabilitation center.


METHODS
One hundred fifteen patients were included in the study and observed for 1 year.


METHODS
Health-related quality of life (HRQL), coping strategies, compliance, hospitalization, and satisfaction with the care provided.


RESULTS
Complete data sets were obtained from 78 patients with severe airflow obstruction (FEV1 = 41%; predicted +/- SD = 15). Corrections were made for the selective nonresponse, but did not lead to adjustments in outcome scores. In both groups, HRQL scores improved between admission and discharge, but deteriorated 4 months and 9 months after discharge. The only statistically significant short-term effect was found on the "activities" component of HRQL in favor of the control group. No differences were found between groups regarding coping, compliance, and hospitalization. Patients in the experimental group, however, were more satisfied with the care provided by the specialized community nurses.


CONCLUSIONS
The treatment intervention of specialized respiratory home nursing might not have been specific or intensive enough to result in outcome benefits. Secondly, the initial benefits from baseline pulmonary rehabilitation alone may have led to positive outcomes in both patient groups.
Ketelaars
C A
CA
Department of Nursing Science, University of Limburg, Maastricht, The Netherlands.
Huyer Abu-Saad
H
H
Halfens
R J
RJ
Schlösser
M A
MA
Mostert
R
R
Wouters
E F
EF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003152:Community Health Nursing; D005260:Female; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000451:nursing*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012138:Respiratory Therapy / Q000451:nursing*