تاريخ مجلس الدراسات العليا

2021-09-12

اسم الطالب

عبد الرحمن حماد فريح بن عوده

ملخص الرسالة

Purpose This study is designed to determine what impact a structured nurse-led educational program has on patient self management and symptom control of hospitalized COPD patients, hence impacting COPD readmissions to hospitals and the cost for treating chronic diseases in Jordan. Design A randomized controlled trial, conducted from April 2021 to June 2021, included 100 participants who were admitted with COPD to hospitals affiliated with the Jordanian Ministry of Health, and were randomly assigned to the intervention (n = 50) and control groups (n = 50). The difference in COPD Assessment Test (CAT) scores between Jordanian COPD patients who received Health Education Program (HEP) and those who did not is used to determine the imact of HEP on health-related quality of life and symptom control. In addition, hospital COPD readmission to hospitals is calculated as a secondary measure of self management and symptom control in hospitalized COPD patients. Materials and Methods Participants in the intervention group underwent a HEP led by a nurse, and collaborated with a pharmacist, dietician, and physiotherapist. Participants in the control group received only routine care. The main outcome measure was symptom control for a health-related quality of life. Data collection was performed by means of the COPD Assessment Test (CAT) questionnaire where data were collected from patients before and immediately after the educational program. Data were analyzed using Chi-square test, independent t-test, and paired sample t-test at a significance level of 0.05. Results: Compared to the control group, participants in the intervention group showed lower CAT scores. The experimental group had a mean pre-CAT score of 66.02 (SD = 25.03) and a mean post-CAT score of 37.56 (SD). = 26.08). This improvement in the CAT score of the experimental group members was statistically significant, t = 8.360, p = 0.000 On the other hand, members of the control group had a mean CAT score of 73.41 (SD = 24.01) and a mean post-CAT score of 53.41 (SD = 30.15). The difference between CAT pretest and CAT posttest scores in the control group was not significant, t = 2.960, p = 0.090. By the number of participants readmitted, participants in the intervention group showed significantly fewer COPD hospital admissions (p = 0.033) and lower admission rates associated with other chronic diseases (p = 0.018). Meanwhile, the results showed a significant improvement in exercise capacity and health status over time in the nurse-led program group compared to the control group) P < 0. 001(. Demographic factors were tested for gender, age group, marital status, educational level, smoking status and co morbidities for association with COPD - and non - COPD readmissions among sample members. None of the demographic factors had a significant association with COPD - related readmissions. Conclusions: It is recommended that hospitals and health care providers adopt this or similar educational programs, that can be integral components of a nurse-led COPD clinic in order to improve patients' experience with the disease and other comorbidities and reduce the risk of readmission, resulting in reduced cost and improved quality of life. Key Words: Health education programs, Patient Care Planning, COPD, Chronic Obstructive Pulmonary Disease, Primary Nursing Care, Readmission, Self-management, Patient Readmission.