Effects of a care protocol on care outcomes in older nursing home patients with chronic obstructive pulmonary disease.
OBJECTIVE
To evaluate the effects of a care protocol used by community nurses to support nursing home staff in the care of patients with chronic obstructive pulmonary disease (COPD).


METHODS
Matched, randomized case-control trial.


METHODS
Forty-five nursing homes of the New Territories South (NTS) cluster of Hong Kong.


METHODS
Eighty-nine older people (> or =65, present resident of a nursing home in the NTS region, main diagnosis of COPD, at least one hospital admission in previous 6 months) discharged to the nursing homes from the geriatric units of two hospitals.


METHODS
Using a care protocol, community nurses followed up older patients in the experimental group for 6 months after their discharge from the hospitals to the nursing homes.


METHODS
Data on functional, respiratory, and psychological parameters were collected at entry to study and 6 months later with standard measures. Data on hospital service utilization, nursing home staff, and patient satisfaction were also collected at 6 months.


RESULTS
Experimental group participants had significant (P =.008) improvements in psychological well-being. Nursing home staff and experimental group patients were highly satisfied with the use of the protocol. There was no significant difference between the two groups in functional and respiratory outcomes or hospital service utilization.


CONCLUSIONS
Psychological well-being as an important factor in rehabilitation in chronic illness has been much neglected in the literature. Supporting nursing home staff in the care of COPD patients through community nursing visits can enhance older residents' psychological well-being. Psychological aspects of care should be emphasized and incorporated into the delivery of regular nursing home care.
Lee
Diana T F
DT
Department of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China. tzefanlee@cuhk.edu.hk
Lee
Iris F K
IF
Mackenzie
Ann E
AE
Ho
Rosalie N L
RN
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002985:Clinical Protocols; D003152:Community Health Nursing; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D008297:Male; D009735:Nursing Homes; D009740:Nursing Staff; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D015397:Program Evaluation; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D013997:Time Factors