ABSTRACT
Objective To explore the effects of comprehensive rehabilitation on patients with stable chronic obstructive pulmonary disease (COPD) in rural communities.Methods Between June 2010 and June 2012,212 stable COPD patients were randomly divided into management group (n =107) and control group (n =105).All patients received conveutional treatment.In addition,107 stable COPD patients relying on new rural cooperative medical service station in management group underwent community comprehensive rehabilitation including training in respiratory function,exercise training,nutrition intervention and psychological care.Effect of lung function,symptoms (times of acute attack & hospitalization) and quality-of-life (QOL) rated by SF-36 questionnaire between two groups were recorded at Month 6.Results The score changes of QOL had significant inter-group differences between 2 groups for PCS (scores for physical component summary) and MCS (scores for mental component summary) (11.4 ±8.2 vs.1.6 ± 1.2,5.5 ±3.5 vs.2.2 ±0.9,all P ＜0.01).In the scores for physical component summary,the score change of physical function,physiological function,body pain and general health were significantly different between two groups (6.7 ±4.3 vs.1.2 ±0.8,10.9 ±6.3 vs.1.9 ± 1.5,6.4 ±4.7 vs.3.6 ±2.7,3.2 ±2.7 vs.1.6 ± 1.1,P ＜ 0.01).In the scores for mental component summary,the score change of vitality,emotional function,social function and mental health were significantly different between two groups (4.9±3.2 vs.1.9±1.4,2.7±2.1 vs.1.6±1.1,11.6 ±9.2 vs.3.6 ±2.3,6.7 ±4.3 vs.1.4±0.9,P＜0.01).The times of acute attack and hospitalization were obviously lower than those of the control group.No significant inter-group difference existed in lung function.Conclusion Comprehensive rehabilitation may improve the QOL in stable COPD patients in rural communities and reduce their times of acute attack.
ABSTRACT
Objective To evaluate the effectiveness of management for patients with chronic obstructive pulmonary disease (COPD) in stage Ⅰ at new rural cooperative medical facilities.Methods A quasi-experiment design was used for the evaluation of patients registering at Dongcun and Fangyuan subdistrict offices in Haiyang.And 79 COPD cases from Dongcun sub-district offices were selected into the management group while 76 cases from Fangyuan the control group.The measures at the new rural cooperative medical facilities included smoking-free publicity,avoiding a hazardous environment,application of influenza vaccines and training of patients and local general practitioners in essences of COPD prevention and treatment.Except for routine treatment,no special measures were taken for the control group.ResultsSixty-one patients in the management group and 60 in the control group completed a 3-year follow-up.Fifteen patients were smokers during their initial visits in the management group and 13 quitted smoking after a 3-year management.Meanwhile 19 patients were smokers during their initial visits in the control group and 3 of them quitted smoking within the same period.The decrement of BODE index between post-management at year 2&3 and between pre-management was higher in the management group versus the control group within the same period (P ＜ 0.01).The annual average frequencies of common cold,acute attack and physician consultation were obviously lower post-management at year 3 than those pre-management and the control group within the same period ( P ＜ 0.05 ).Lung functions of two groups deteriorated as compared with those 3 years before ( P ＜ 0.05).But no statistical difference existed between two groups (P ＞ 0.05).ConclusionThe management of COPD patients in stage Ⅰ at new rural cooperative medical facilities can improve their quality of life and reduce their frequencies of common cold,acute attack and physician consultation.
ABSTRACT
Objective To understand awareness of basic concepts, diagnosis, treatment and patient education for chronic obstructive pulmonary disease (COPD) among practitioners in rural new cooperative medical scheme (NCMS) and evaluate effectiveness of training for them in Haiyang, Shandong.Methods In total, 116 practitioners, two or three randomly selected from each of 43 NCMS service stations under the Third People's Hospital of Haiyang, were surveyed with questionnaire and then systematic training was provided for them. Another survey was conducted among them a half and two years after the first one with the same questionnaire. Results At the first survey, only 9.5 % (11/116) of the practitioners surveyed knew about "Guidelines for Prevention and Control of Chronic Obstructive Pulmonary Disease",19. 8 % (23/116) knew clinical characteristics of COPD, 29. 3 % (34/116) knew that pulmonary function test is gold standard for COPD diagnosis, 62. 9 % (73/116) knew that smoking is major inductive factor for COPD and could persuade patients to quit smoking, only 2.6 % (3/116) could make registration for the patients and provide health education for them, 48. 3 % (56/116) knew that the patients should be immunized with influenza vaccine, and 7. 8 % (9/116) knew long-term oxygen therapy for the patients. At the second survey, 94. 8 % (110/116) of the practitioners surveyed knew about " Guidelines for Prevention and Control of Chronic Obstructive Pulmonary Disease", all of them knew characteristics of COPD, that pulmonary function test is gold standard for COPD diagnosis, smoking is major inductive factor for COPD,could make registration for COPD patients and provide health education for them, 99. 1% (115/116) used influenza vaccine for COPD patients, and 99. 1% (115/116) knew long-term oxygen therapy for the patients. Conclusions Systematic training for COPD knowledge among practitioners in rural NCMS seems to be significantly beneficial for their awareness about the illness and to improve their abilities of prevention and treatment for it in rural areas.