Effects of nurse-led case management on the self-care and health behaviors of the patients with chronic obstructive pulmonary disease in community health service

Abstract

Objective To analyze the effects of nurse-led case management on the self-care and health behaviors of the patients with chronic obstructive pulmonary disease (COPD) in community health service.Methods The groups were randomly divided based on the unit of community.According to the sampling results,a total of 67 patients participated in and completed the study,including the study group with 32 patients using the nurse-led case management nursing care,and the control group with 35 patients using conventional nursing method.The self-care agency scale (ESCA) and health promoting lifestyle profile (HPLP) were used to evaluate the changes of patients' self-care and health behaviors.Results After one-year intervention,the scores of health knowledge,self-responsibihty,self-care skills and self-care in the study group were significantly higher than those scores before intervention (P ＜ 0.05).At baseline,the scores of the patients in the control group and in the study group had no significant difference (P ＞ 0.05).But after the intervention,the scores,except for the aspect of self-concept,in the study group were significantly higher than those in the control group (t =-3.49,-5.78,-11.39,-7.54,respectively; P ＜ 0.01).After one-year intervention,the total scores and the scores of each dimensions of HPLP in the study group were significantly higher than the scores in the control group (t=-2.93,-2.32,-3.07,-4.47,-9.22,-5.63,-14.53,respectively; P＜0.05).In addition,the scores in each dimension of the study group were significantly higher than the scores before the intervention (P ＜ 0.05).Conclusions The nurse-led case management can significantly promote the self-care ability and the health behaviors of the patients with COPD in community health service,so as to enhance their self-management skills.It is an effective way to implement quality community nursing. Key words: Case management; Nursing; Pulmonary diseases,chronic obstructive; Self-management