title: A new mode of community continuing care service for COPD patients in China: participation of respiratory nurse specialists.
abstract: OBJECTIVE
  This study explored a community nursing service mode in which respiratory nurse specialists cared for patients with chronic obstructive pulmonary disease (COPD) in a 12-week period after hospital discharge, with the aim of better preventing acute exacerbations, improving health-related quality of life (HRQOL) and reducing medical expenses in these patients.
  
  
  METHODS
  We carried out a prospective randomized controlled study in which 68 COPD patients discharged were recruited from a general hospital in Guangzhou, China, were randomized divided into two groups. The control group underwent conventional nursing care, and the intervention group received community continuing care by respiratory nurse specialists. The observation period was 12 weeks. The results of intervention were evaluated using the Seattle Obstructive Lung Disease Questionnaire (SOLDQ) and the COPD Self-Efficacy Scale (CSES). In addition, the frequency of acute exacerbations, emergency treatments or hospitalizations, and medical expenses were recorded in the 12-week observation period.
  
  
  RESULTS
  After six weeks, the total and subscale scores (P < 0.05) of SOLDQ and CSES significantly improved compared to the baseline ones in the intervention group. The control group had significantly higher scores in the treatment satisfaction (TS) of SOLDQ, the total score, and the weather/environment and behavioral risk factors of CSES. After 12 weeks, the total and subscale scores of SOLDQ and CSES showed a sustained and significant growth in the intervention group (P < 0.05). The control group had significantly higher scores only in the weather/environment risk factor of CSES. During the 12-week observation, the intervention group had significantly fewer acute exacerbations, emergency treatments or re-hospitalizations and significantly lower average medical expenses than the control group (P < 0.05).
  
  
  CONCLUSIONS
  Community continuing care by respiratory nurse specialists may improve HRQOL, increase self-efficacy, reduce incidence of acute exacerbation, and lower medical expenses in patients with COPD after hospital discharge.
authors.affiliation: Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University Guangzhou 510120, Guangdong.
authors.forename: Pingdong
authors.initials: P
authors.lastname: Li
authors.affiliation: Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University Guangzhou 510120, Guangdong.
authors.forename: Yucui
authors.initials: Y
authors.lastname: Gong
authors.affiliation: State Key Laboratory of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University Guangzhou 510120, Guangdong.
authors.forename: Guangqiao
authors.initials: G
authors.lastname: Zeng
authors.affiliation: Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University Guangzhou 510120, Guangdong.
authors.forename: Liang
authors.initials: L
authors.lastname: Ruan
authors.affiliation: Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical University Guangzhou 510120, Guangdong.
authors.forename: Guifen
authors.initials: G
authors.lastname: Li
keywords: Community continuing care; chronic obstructive pulmonary disease; health-related quality of life (HRQOL); respiratory nurse specialists