The effectiveness of an unsupervised home‐based pulmonary rehabilitation with self‐management program in patients with chronic obstructive pulmonary disease

• Published in: International journal of nursing practice Vol. 29; no. 6; pp. e13185 - n/a
• Main Authors: Liou, Huey L., Lai, Zi Y., Huang, Yu T., Chu, Wan T., Tsai, Ya C., Chen, Mei S., Tsai, Pei C.
• Format: Journal Article
• Language: English
• Published: Australia Wiley Subscription Services, Inc 01.12.2023
• Subjects: Chronic obstructive pulmonary disease; Clinical outcomes; Dyspnea; Efficacy; Exercise Therapy - methods; Humans; Intensive care; Medical research; Patient admissions; Physical activity; Pulmonary Disease, Chronic Obstructive - rehabilitation; pulmonary rehabilitation; Quality of Life; quasi‐experiment; Questionnaires; Rehabilitation; Self care; Self Care - methods; Self-Management; self‐efficacy; self‐management program; dyspnea; pulmonary rehabilitation; self-management program; quasi-experiment; self-efficacy; chronic obstructive pulmonary disease
• DOI: 10.1111/ijn.13185
• ISSN: 1322-7114

Aims To assess the effectiveness of an unsupervised home‐based pulmonary rehabilitation with self‐management program in patients with chronic obstructive pulmonary disease (COPD). Background A few recent studies have shown that unsupervised home‐based pulmonary rehabilitation can improve the clinical outcome of patients with COPD. More studies are needed to prove its benefits. Design This study used a quasi‐experimental design. Methods Seventy‐two admitted COPD patients were assigned to experimental group or control group through purposeful sampling. Data were collected from March 2016 to November 2017 in the Thoracic Intensive Care Unit of a Medical Center in Taiwan. The Medical Research Council dyspnea scale, the COPD Self‐Efficacy Scale and the Clinical COPD Questionnaire were measured before education and at the first, second and third months after discharge. Results The Medical Research Council dyspnea scale and COPD Self‐Efficacy Scale results in the experimental group were significantly improved compared with the control group in the third month after discharge. The Clinical COPD Questionnaire score continued to improve in both groups in the third month after discharge, and there was no difference between the two groups. Conclusion A short‐term unsupervised home‐based pulmonary rehabilitation with self‐ management program had significant benefits for patients with COPD. The long‐term effects need to be confirmed. Summary statement What is already known about this topic? The literature emphasizes the importance of alternative supervision of home‐based pulmonary rehabilitation rather than center‐based pulmonary rehabilitation for patients who find this inconvenient to access. Few studies have shown that unsupervised home‐based pulmonary rehabilitation can improve the clinical outcome of patients with chronic obstructive pulmonary disease (COPD). What this paper adds? This study demonstrates that a short‐term unsupervised home‐based pulmonary rehabilitation with self‐management program can improve dyspnea during physical activity, self‐care efficacy in certain activities and quality of life after discharge in patients with COPD. The implications of this paper: The findings of this study can be used as the basis for providing a short‐term unsupervised home‐based pulmonary rehabilitation with self‐management program for patients with COPD after discharge. We recommend that patients with COPD undergo unsupervised home‐based pulmonary rehabilitation with self‐management for 3 months after discharge, especially if regular hospital visits for this are not convenient. The effect of longer‐term unsupervised home‐based pulmonary rehabilitation can be further studied in the future.