To Study The Role Of Respiratory Team In Rehabilitation And Nursing In Patients With COPD

Objective:The purpose of the research was to build a collaborative team named Respiratory Team for Chronic obstructive pulmonary disease (COPD) through introducing foreign advanced management experience for chronic respiratory disease in the point of chronic diseases management view. Primarily make the team work plan, next provide personalized, systematic and comprehensive services of rehabilitation and nursing through the team member’s collaboration for improving the quality of life for COPD patients, reducing their economic burden and social burden due to the disease, and saving medical and health resources.Methods:Primly drawed up the framework of team work by literature review, consulting experts about treatment and rehabilitation of respiratory system desease, learning from foreign advanced team management programe for COPD rehabilitation, and contrasting with China’s health care system and the local medical health resource status. Then used it in the process of rehabilitation and nursing for COPD patients. The research selected120patients with COPD in Ⅱ-Ⅳ level in pneumology department of the Affiliated Hospital in Zunyi Medical College from February2010to February2011and living in the two distriction of ZunYi city and Zun Yi county. They were divided into two big groups, the rehabilitation group (base number) and the control group (the even number), according to the principle of base number or even number when collecting the data of all levels COPD.Each group consisited of20patients in every level of Ⅱ,Ⅲ,Ⅳ,60patients in total. The rehabilitation group patients were managed by team’s work programe to implemente comprehensive measures of rehabilitation and nursing from hospital to community where patients lived in. In the meantime, the control group patients were managed by present conventional treatment and nursing of pneumology department. Two groups were followed-up visit for one year after discharge from hospital. Two groups of patients were measured evaluation index such as exercise endurance (BODE index), quality of life (SGRQ). lung function (FEV,, FEV1/FVC, FEV1/Pred) and the psychological condition (SAS, SDS) etal.when they admited to hospital. after discharged for the sixth month and the first year form hosipal. All data were received analvzed and processed by SPSS17.0package software, the results expressed by mean±standard deviation (x±s), P<0.05indicated the difference had statistical significance.Results:1.There were no statistically significant difference (P>0.05) in the general data, BODE index, SGRQ and lung function testing results, SAS, and SDS comparison of two groups of patients under the same disease classification level.2.The third month when they discharge from hosipal, the SGRQ total score and the component (symptoms points, activity points, influence points) scored of the rehabilitation group patients in level of Ⅱ, Ⅲ, Ⅳ are lower than the control group ones in the same level of illness.the difference was statistically significant (P<0.05).3. The results of comparison for each evaluation index in the sixth month and the first year from they discharge form hosipal:(1) The BODE index:The sixth month when they discharge from hosipal, for patients with COPD in Ⅱ and Ⅲ level, the total score of BODE index and MMRC score of rehabilitation group were lower than the control group under the same level, but the6MWD was higher than the control group (P<0.05); No difference of BMI and FEV1/Pred comparison between two groups at the corresponding levels (P>0.05). The first year when they discharge from hosipal. for patients with COPD in Ⅱ and Ⅲ level, the total score of BODE index and MMRC score of rehabilitation group were lower than the control group under the same level, but the BMI, FEV1/Pred,6MWD was higher than the control group (P<0.05).Tor patients with COPD in Ⅳ level, there were no significantly differences of the total BODE score, BMI, FEV,, MMRC and6MWD between two groups(P>0.05).(2) The SGRQ score:there were no ignificantly differences of the total score of SGRQ and symptoms points, activities points, and influence points between two groups of patients with COPD at all levels (P<0.05).(3) The lung fuction:there were no significantly differences of the FEV1, FEV1/FVC. FEV]/Pred between two groups of patients with COPD in all levels (P<0.05).(4)SAS\SDS score:the SAS and the SDS score of of the rehabilitation group of patients with COPD are lower than the control group ones in all levels (P<0.05).4. The patient satisfaction scores of rehabilitation group patients are higher than the control group’s in all levels on the time of discharge from the hospital (P<0.05). The average day in hospital, average medical treatment cost, hospital readmission rates in one year since discharge were lower than those of the control group (P<0.05):but there were no obvious differences of above COPD patients in Ⅳ level’s (P>0.05). Conclusion:The Respiratory Team can effectively alleviate the despnea symptoms of COPD patients, strengthen activities endurance, delay the desease progresses, improve nutriet level, alleviate psychological burden, and effectively improve the quality of life. At the same time, Respiratory Team can shorten the average days in hospital, reduce the hospital readmission rate, cut down the average medical treatment cost and reduce the disease burden of economy, further save medical and health resources for patients with COPD.