| Objective This study aims to explore the application effect of active cycle of breathing technique based on the model of nurse-patient consensus for acute exacerbation of chronic obstructive pulmonary disease(AECOPD)patients in pulmonary rehabilitation exercise,in order to provide new intervention strategies and methods for pulmonary rehabilitation care of AECOPD patients.Methods This study is a quasi-experimental research.A total of 104 AECOPD patients admitted to a tertiary hospital’s respiratory department in Hangzhou were selected as the research subjects and were randomly divided into an experimental group and a control group,with 52 cases in each group.The control group received routine chest physiotherapy,such as deep breathing,effective coughing,and back tapping.The experimental group received an intervention plan using active cycle of breathing technique intervention based on the model of nurse-patient consensus on the basis of routine care.The intervention period was one week,during which both groups received two nursing interventions per day.After discharge,patients continued to exercise and were followed up for one month.Using a general information survey form to record the basic information of two groups of patients,and using a systematic evaluation survey form to assess the consensus achievement rate of the experimental group.Comparing the differences in arterial blood gas analysis,coughing and sputum clearing ability,degree of respiratory distress,and activity endurance before and after intervention between the two groups,as well as the differences in quality of life and compliance with pulmonary rehabilitation exercises after follow-up for one month.Software SPSS24.0 was used for data analysis.Using mean,standard deviation(x±s)to describe quantitative data;using rate,frequency,and percentage to describe the demographic data.T-test,chi-square test,non-parametric rank-sum test,and one-way ANOVA were used for statistical analysis.The significance level of the hypothesis test was set to α=0.05,and P<0.05 was considered statistically significant.Results 1.The complete number of cases for data collection in this study was 51 in the experimental group and 50 in the control group.There were no significant differences in age,gender,body mass index,duration of COPD,education level,and number of comorbidities between the two groups(P>0.05).In addition,there were no significant differences in baseline oxygen partial pressure、oxygenation index,carbon dioxide partial pressure,cough frequency,dyspnea assessment,6-minute walking distance,and chronic obstructive pulmonary disease assessment score between the two groups before the intervention(P>0.05).2.The consensus achievement rate in the experimental group after the intervention of nurse-patient consensus mode was 98.04%,which was significantly higher than the 74.51%before the intervention,and the difference was statistically significant(P<0.05).3.Within-group comparison:After intervention,there were significant improvements in oxygenation index,carbon dioxide partial pressure,dyspnea assessment,6-minute walking distance,and chronic obstructive pulmonary disease assessment score in both groups,and the differences were statistically significant(P<0.05).4.Between-group comparison:After intervention,The experimental group had significantly higher oxygenation index(301.90±17.02)than the control group(280.91±32.15),significantly lower carbon dioxide partial pressure(50.62±6.53)mmHg than the control group(58.58±5.05)mmHg,significantly lower dyspnea assessment score(1.80±0.87)than the control group(2.18±0.87),significantly longer 6-minute walking distance(271.06±9.92)meters than the control group(239.12± 10.94)meters,and significantly lower chronic obstructive pulmonary disease assessment score(23.59±3.28)than the control group(26.26±2.79),and all differences were statistically significant(P<0.05).5.The time effect,inter-group effect,and interaction effect differences of sputum frequency in the two groups of patients were statistically significant(P<0.05)after repeated-measures analysis of variance.Separate effect tests for time effect and inter-group effect showed that in the first five days of the intervention period,the cough frequency in the experimental group was significantly higher than that in the control group.On the 6th to 7th day of the intervention,the expectorated sputum frequency in the experimental group was less than that in the control group,and the difference was statistically significant(P<0.05).Over the entire intervention period,the expectorated sputum frequency of both groups showed an initial increase followed by a decrease trend,and the peak of sputum production in the experimental group was one day earlier than that in the control group,and the difference was statistically significant(P<0.05).6.During the follow-up period,the check-in rate of pulmonary rehabilitation exercise in the experimental group was 96.93%,higher than that of the control group which was 87.73%.The number of active check-ins in the experimental group(24.22± 1.96)was more than that in the control group(17.90±2.35),and the number of missed check-ins(1.02±0.99)was lower than that of the control group(3.68± 1.54).The difference between the groups was statistically significant(P<0.05).Conclusion The consensus mode of nurse-patient communication can effectively improve patients’ compliance and enthusiasm for exercise,further optimizing the effect of pulmonary rehabilitation.This can make the Active Cycle of Breathing Technique more effective in enhancing the coughing and sputum-clearing ability,relieving respiratory difficulties,improving blood gas indicators,increasing exercise endurance,and improving quality of life for patients with acute exacerbations of chronic obstructive pulmonary disease(AECOPD).This method is practical,safe,effective,and suitable for clinical promotion. |
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