Effect of Enhanced Psychological Nursing Combined with Graded Pulmonary Rehabilitation in Elderly Patients with COPD: A Randomized Controlled Trial : Effect of Enhanced Psychological Nursing in Elderly Patients with COPD

强化心理护理联合分级肺康复治疗对老年慢性阻塞性肺疾病患者的影响:一项随机对照试验:强化心理护理对老年慢性阻塞性肺疾病患者的影响

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Abstract

BACKGROUND: This research aimed to investigate the therapeutic effectiveness of combining structured psychological support with a stepwise pulmonary rehabilitation regimen in older adults diagnosed with stable chronic obstructive pulmonary disease (COPD). MATERIALS AND METHODS: In this randomized controlled trial, 120 elderly patients with stable COPD were evenly assigned into two groups (n=60). The control group underwent conventional pharmacologic therapy and standard nursing care. In contrast, the intervention group received additional enhanced psychological interventions along with a progressive pulmonary rehabilitation protocol aligned with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommendations. Outcomes assessed before and after the intervention included psychological health indicators, lung function metrics, compliance with treatment, rate of acute exacerbations, six-minute walk distance (6MWD), and quality of life. RESULTS: While both groups experienced notable improvements in anxiety, depressive symptoms, and psychological resilience, these changes were significantly more favorable in the intervention group (P0.05). Pulmonary function indicators, namely FEV1%, FEV1/FVC, and peak expiratory flow (PEF), showed measurable improvements across both groups, with the intervention group exhibiting more marked progress. Additionally, patients in the intervention group showed higher adherence to treatment, fewer acute exacerbation episodes, and a greater increase in 6MWD over the 12-month follow-up period. Quality of life, assessed via the St. George's Respiratory Questionnaire, demonstrated more pronounced enhancements in respiratory symptoms, physical activity, and overall disease burden in the intervention group (P0.05 across all domains). CONCLUSION: Incorporating targeted psychological support and a graded pulmonary rehabilitation strategy yields substantial benefits in emotional well-being, pulmonary performance, adherence levels, and life quality in elderly COPD patients. This comprehensive care model may serve as an effective approach for sustained disease management in this population.

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