Abstract
Objective To explore the effect of hierarchical mode in family rehabilitation in out-of-hospital nursing of elderly patients with chronic obstructive pulmonary disease (COPD) . Methods The elderly patients with COPD at stable stage in two communities were divided into the observation group (n=33) and the control group (n=31) based on the unit of community. The observation group was managed by family oxygen therapy and rehabilitation training guided by hierarchical mode, while the control group received routine community care for chronic diseases. Exercise of Self-Care Agency Scale (ESCA) and Health Promoting Lifestyle Profile (HPLP) were used to compare the intervention effect of the two groups and count the acute episodes of COPD during the intervention period of the two groups. Results Before intervention, there were no statistical differences in both of the dimensional scores of ESCA and HPLP scales between the two groups (P> 0.05) . After 12 months of intervention, the dimensional scores of health knowledge (41.76±6.20) , self-responsibility (22.94±8.22) , and self-nursing skills (25.85±6.46) in ESCA of the observation group were higher than those of the control group with statistical significance (t=2.894, 4.138, 6.096; P< 0.05) ; in the observation group, the dimensional score of health responsibility was (23.79±7.44) , mental growth was (16.70±3.73) , stress management was (17.09±5.44) , interpersonal relationship was (17.97±4.54) , sports activity was (15.70±4.57) , nutrition was (16.70±4.10) , all higher than the control group with statistical significance (t=3.184, 3.365, 3.212, 5.277, 5.131, 4.589; P<0.05) . Within the 12 months of intervention, there were 11 cases in the observation group and 4 cases in the control group without acute episodes of COPD, and the difference was statistically significant (Z=2.166, P<0.05) . Conclusions Hierarchical mode infamily rehabilitation can effectively improve the elderly COPD patients' compliance of family oxygen therapy and rehabilitation training, hence improve their prognosis. Key words: Aged; Pulmonary disease, chronic obstructive; Hierarchical management; Community management; Stable stage
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