| ObjectivesTo explore the fatigue in patients with chronic obstructive pulmonary disease(COPD) who were hospitalized, and analyze the factors related to fatigue in patientswith COPD. Observe the effect of the staged nursing intervention on fatigue inpatients with COPD, verify the effectiveness of the staged nursing intervention bycomparing the effect of the staged nursing intervention to the effect of conventionalnursing, and provide the scientific basis of application in patients with COPD.MethodsThis study was a Quasi-experimental survey. From December2010to May2011,the patients with COPD who were hospitalized for acute exacerbation in the secondNanchang university affiliated hospital were selected to be samples. Inpatients withCOPD in the acute exacerbation stage were divided into the experimental group ofpatients and the control group of patients by the ward numbers. The patients in thecontrol group received only routine care. The experimental group received the stagednursing intervention according to the course of COPD. Provide psychological care,cognitive care and life behavioral care to the patients at acute exacerbations of COPD,respiratory functional care and physical exercise care at stability stage of COPD. Theintervention effects were evaluated by using multidimensional fatigue inventory andhospital anxiety and depression scale.ResultThe baseline results showed that the score of fatigue in patients with COPD was(58.32±12.14). Reduced activity was the MFI subscales with the highest score at(13.43±3.15) and reduced motivation was the MFI subscales with the lowest score at(9.33±3.03). Multiple linear regressions indicated that anxiety, depression, course ofdisease and appetite were the independent influential factors of fatigue in patientswith COPD. The decreasing levels of fatigue (MFI) and the five subscales of generalfatigue, physical fatigue, reduced activity, reduced motivation and mental fatiguewere significant in experimental group between pre and post intervention(P<0.05). The decreasing levels of the four subscales of general fatigue, reduced activity,reduced motivation and mental fatigue were not significant in control group betweenpre and post intervention (P>0.05).The scores of fatigue (MFI) and the four subscalesof general fatigue, physical fatigue, reduced activity and reduced motivation of theexperimental group were lower than those of the control group after intervention,there were all statistical differences (P<0.05), but mental fatigue (P>0.05). Thedecreasing levels of HAD and the two subscales of anxiety and depression weresignificant in experimental group between pre and post intervention (P<0.05). Thedecreasing levels of HAD and the two subscales of anxiety and depression were notsignificant in control group between pre and post intervention (P>0.05). The scores ofHAD and the two subscales of anxiety and depression of the experimental group werelower than those of the control group after intervention, there were all statisticaldifferences (P<0.05).ConclusionReduced activity was the MFI subscales with the highest score and reducedmotivation was the MFI subscales with the lowest score. Anxiety, depression, courseof disease and appetite were related to fatigue in hospitalized patients with COPD.The staged nursing intervention can relieve fatigue, anxiety and depression inhospitalized patients with COPD. |
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