Partnership-based nursing practice for people with chronic obstructive pulmonary disease and their families: influences on health-related quality of life and hospital admissions.

AIMS AND
OBJECTIVES: To evaluate the outcome of a coherent nursing practice in the form of partnership that addresses the complexity of living with chronic obstructive pulmonary disease.
BACKGROUND: Chronic obstructive pulmonary disease is a wide-ranging and progressive chronic disease that not only requires relentless attentiveness of the persons having the disease but also the families involved. Particular consideration is called for in health care for those with an advanced and complicated stage of the disease. The nursing practice, grounded in the theoretical framework of 'partnership as practice', is participatory comprehensive, long-term and dynamic to individual patient-family needs.
DESIGN: Retrospective and prospective pretest-post-test intervention study. Methods.  Eleven men and 39 women participated (n = 50). Mean age was 66 years. The majority (n = 36) had severe chronic obstructive pulmonary disease (GOLD stage III and IV). Actual study period was six months (T2). Hospital admission data were collected six months prior to (T1) and six months after that period (T3), a total of 18 months.
RESULTS: Hospital admission rate and days spent in hospital because of chronic obstructive pulmonary disease were significantly reduced. Disease-specific health-related quality of life measured by St. George's Respiratory Questionnaire improved significantly. For those with clinical anxiety and depression, both decreased significantly. Of those who were underweight, body mass index improved significantly. Abstinence from smoking changed non-significantly. Capability in the use of inhaler medications improved.
CONCLUSIONS: These results are in contrast to previous studies on outpatient nursing care for people with chronic obstructive pulmonary disease. The participatory nature of partnership with dialogue as central and which was uniquely implemented in this study might be of particular relevance for individuals and families living with chronic obstructive pulmonary disease. RELEVANCE TO CLINICAL PRACTICE: Complex and comprehensive health needs of people with chronic obstructive pulmonary disease and their families may be effectively addressed in partnership centred on dialogue together with efficient intra-and interdisciplinary collaboration.