الفهرس 
الملخص العربىOnly 14 pages are availabe for public view
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Abstract
Chronic obstructive pulmonary disease (COPD) is a cause of chronic morbidity and mortality throughout the world. COPD is currently the fourth leading cause of death in the world and further increases in the prevalence and mortality of the disease can be predicted in the coming decades (World Heath Organization, 2000).
One key component in the management of patients with COPD is pulmonary rehabilitation, the corner stone of which is exercise training. COPD patients at all stages of disease could benefit from exercise training program, however it is of great value in COPD patients with a disability (advanced stages) (Berry et al., 1999).
The principal goals of pulmonary rehabilitation are to
reduce symptoms, improve quality of life, and increase physical and
emotional participation in every day activities (Weisman, 2000).
The aim of the present study was to determine the effect of nursing rehabilitation program on respiratory status and quality of life of COPD patients. The study was carried out in Chest Department and out patient Chest Clinic in Assiut University Hospital.
Thirty nine adult patients with moderate to severe COPD were included in this study. Study group included twenty five patients and control group consisted of fourteen patients. All the included patients received the same routine medical treatment and nursing care, while pulmonary rehabilitation scheduled program was applied to the study group only in addition to routine medical treatment. Pulmonary rehabilitation scheduled program was developed by the researcher under the guidance of Global Initiative for, Chronic Obstructive Lung Disease, 2003.
1- The tool of the study:
Two tools were designed and used to collect necessary data for this study
First tools include (A) Sociodemorgraphic data, (b) Respiratory status include (Arterial blood gases (ABGs) and pulmonary functions tests (PFT)) (c) Measures outcome (6-min walk test, the chronic respiratory disease questionnaire (CRDQ) and Medical outcomes survey: short-form 36. Second tool: This included pulmonary rehabilitation program based on review of recent literature related to COPD and its management.
Within the hospitalization period, included patients were interviewed four times about one hour each. The first interview was done after 48 hours following stabilization of the patient condition to collect the base line data using the first tool. Also, second tool interview was used for program implementation.
Assessment was carried out every two weeks. Follow-up parameters included: blood gases, pulmonary function test, 6 minutes walk test, score of the quality of life of the patients. They were done for each patient after discharge through two months to evaluate the effective of program. Evaluation of the program was based on finding difference or no difference between the control and study group.
The implementation period of the program started from March 2002, to March 2005.
Main findings of the present study were as the following:
The range of ages of both groups were between (35 to 75) years with a mean ±SD (56.96±11.59).
Majority of both groups living in rural area and were illiterate and Cigarette smoking with or with out dusty jobs were higher risk factor recorded among most patients in either two groups. Mean of duration of illness (10.80±6.35) of the rehabilitation group while (10.43±8.64) control group.
As regard blood gases it was found that Statistical Significant difference change in PCO2 at end of the study in comparing rehabilitation group and Control group (P<0.05).
Statistical Significant difference change was found between the rehabilitation and control group as regards PO2at beginning and end of the study (P<0.01).
Concerning pulmonary function tests, it was found highly statistical significant difference change were found between the rehabilitation and control group as regards FVC (in liters) /m ,FVC %( %of predictd ),FEV1 (in liters)/m FEV1 %( %of predictd) and PEF.Rate, PEF %( %of predictd) at beginning and end of the study (P<0.001).
As regard FEV1/ FVC% low Statistical Significant difference change was found between the rehabilitation and control group at beginning and end of the study(P<0.05).
Highly Statistical Significant increase in the six -min walk distance with a mean±SD before program (88.79±19.14) that reached(121.71±23.11) after program (p<0.001).Also there was Significant decrease in the number of patients, stops while walking .
Statistical Significant difference was found between the rehabilitation and control group as regards total mean score of chronic respiratory questionnaire and The MOS36 SF Health survey at the beginning of the study (P<0.05).While very highly statistical Significant difference change between total mean score at the end of the study (P<0.001).
Concerning MOS36 SF Health survey for rehabilitation group a highly statistical significant difference change in five of the nine SF36subscales (Physical functioning- Role limitation due to Physical health- Role limitation due to emotional problem - health Change) While not statistical significant difference change in (Social function- Energy fatigue - Emotional well –being- General health) Following rehabilitation .compared to control group it was found not statistical significant difference change of SF36subscales.
Statistical Significant difference change was found between the rehabilitation and control group as regards all subscales of chronic respiratory questionnaire at beginning and end of the study(P<0.001).
As regard correlation between demographic variable and total score level of chronic respiratory questionnaires it was found that educated COPD patient showed statistically significant improvement compared to not educated(p<0.05).
Concerning correlation between demographic variable and total score level of The MOS36 SF Health survey it was found farmer COPD patient showed statistically significant improvement compared to worker patient(p<0.01).