Pulmonary rehabilitation based care bundle for patients with chronic obstructive pulmonary disease

2019 
Background: Dyspnea, shortness of breathing and fatigue are the most common symptoms experienced by patients with COPD.Aim: To assess the effectiveness of pulmonary rehabilitation as practiced based care bundle on improving dyspnea, fatigue, functional status, quality of life and knowledge for patients with chronic obstructive pulmonary disease.Design: Quasi experimental (pre posttest control trial). Setting: Chest Department, Aswan University Hospital.Subjects: A purposeful sample of100 patients suffering from COPD divided into two groups (Study and control)Tools: 7 tools were used: (I) Socio-demographic and medical clinical base line data, (II) St. George’s Respiratory Questionnaire (SGRQ), (III) The University of California, San Diego (UCSD) Shortness of Breath Questionnaire, (IV) The Medical Research Council (MRC) Breathlessness Scale, (V) Dyspnea-12 Questionnaire, (VI) The Multidimensional Fatigue Symptom Inventory Short Form (MFSI-SF) and (VII) Bristol COPD knowledge questionnaire (BCKQ).Results: All of the studied patients had unsatisfactory knowledge and the minority of them had unsatisfactory practices regarding dyspnea and fatigue management before the pulmonary rehabilitation program, which improved after the program intervention with a highly significant differences. The breathlessness, fatigue and shortness of breathing improved in patients with COPD who received the program.Conclusions: Implementation of the pulmonary rehabilitation program had improved COPD patients' level of knowledge, dyspnea, dimensions of fatigue and shortness of breathing and breathlessness level.Recommendations: Conducting comprehensive rehabilitation programs for patients with COPD in outpatients' clinics with simplified printed guidelines through leaflets or brochures explaining how to prevent and control breathlessness and fatigue.
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