| Objective: To understand the situation of discharge preparation for patients with COPD;to construct a continuous nursing intervention program based on timing it right in combined with the changes of experience and needs of patients with COPD at different stages of disease;and to evaluate the effects of the program on the hospital's readiness,efficacy,quality of life for patients with COPD.Method: 90 patients with COPD who met the exclusion criteria were admitted in the Department of Respiratory Medicine of Renmin Hospital of Wuhan University from October 2017 to April 2018.The random number table was used to divide them into experimental group and control group,with 45 cases in each group.Both groups received routine nursing and discharge follow-up during hospitalization.The experimental group also accepted continuous care based on timing it right.The specific measures were to form an intervention team and develop a continuous nursing intervention program based on timing it right.According to the full-course health education manual for COPD,implement continuous nursing guidance and follow-up which included the whole process from hospitalization and discharge to post-recovery in community or families.Readiness for Hospital Discharge Scale,COPD Quality of Life Score Scale,and the Self-efficacy Scale for Chronic Disease were used at discharge,discharge after 3 months and 6 months to evaluate the readiness and rehabilitation of the two groups,and average hospital stay and readmission were also counted at the same time.Data were entered and analyzed by SPSS22.0.Finally,repeated measures analysis of variance,two independent sample T test and chi-square test were used to compare the differences of each evaluation index.Results: A total of 87 patients finished the study,with 44 in the experimental group and 43 in the control group.There was no significant difference between the general data and the baseline data of each evaluation index of the two groups(P>0.05).After implementing the continuous nursing intervention based on timing it right,the results showed that:(1)The total scores and the scores of dimensions of discharge readiness of the experimental group were higher than that of the control group at discharge.There were statistically significant(p<0.05).(2)After the intervention,the difference of total scores and scores of dimensions of Self-efficacy between the two groups had statistically significant(P<0.001)among the effect of time,inter group and interaction.Both the two groups' scores of self-efficacy wereimproved with time.And the degree of the experimental group was better than that of the control group.(3)After the intervention,the difference in both the total scores and the scores of each dimension of quality of life of the two groups had statistically significant(P<0.001)among the effect of time,inter group and interaction.The scores of quality of life between the two groups showed a downward trend with time,but the degree of decline was different.Especially,the experimental group showed a significant decrease compared with the control group after 3 months of discharge.(4)At discharge,the average hospital stay in the experimental group was significantly lower than that in the control group(P<0.05).At 6 months after discharge,the readmission rate of the experimental group was significantly lower than that of the control group(P<0.05).However,between the two groups,there was no significant difference in the readmission rate at 30 days and 3 months after discharge(P>0.05).Conclusion: Continuing care based on timing it right can help patients with COPD improve discharge readiness effectively,and at the same time,it can not only improve the patients' quality of life and self-efficacy continuously,but also help them shorten the average length of hospital stay and decrease the readmission rate within 6months. |
PDF Full Text Request