# 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

## TL;DR

Combining psychological support with step-by-step pulmonary rehab improves outcomes for elderly COPD patients.

## Contribution

A new integrated care model for COPD combining psychological and pulmonary rehabilitation is shown to be effective.

## Key findings

- The intervention group showed greater improvements in psychological health and lung function.
- Patients in the intervention group had higher treatment adherence and fewer exacerbations.
- Quality of life improvements were more pronounced in the intervention group.

## Abstract

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).

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.

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).

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.