Effects of Pulmonary Rehabilitation Nursing on Pulmonary Function and Exercise Capacity in Patients With COPD: A Meta-Analysis.

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is associated with persistent airflow limitation, reduced exercise tolerance, dyspnoea, impaired quality of life and recurrent hospitalizations. Pulmonary rehabilitation is a key component of COPD management, but the specific contribution of pulmonary rehabilitation nursing has not been comprehensively synthesized.

AIM: This meta-analysis evaluated effects of pulmonary rehabilitation nursing on pulmonary function, exercise capacity, health-related quality-of-life and hospital admissions in patients with COPD.

STUDY

DESIGN

Systematic review and meta-analysis.

METHODS

Electronic databases were searched to identify studies evaluating pulmonary rehabilitation nursing in adults with COPD. Outcomes included forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, 6-min walk distance (6MWD), modified Medical Research Council (mMRC) dyspnoea scale, Borg scale, St George's Respiratory Questionnaire (SGRQ), COPD Assessment Test (CAT) and hospital admissions/readmissions. Random effects meta-analysis was performed using standardized mean differences (SMD), weighted mean differences (WMD) and risk ratios (RR) with 95% confidence intervals (CI).

RESULTS

Nineteen studies involving 1472 participants were included. Pulmonary rehabilitation nursing significantly improved FEV1 (SMD = 0.41, 95% CI, 0.11-0.71), FEV1/FVC (SMD = 0.57, 95% CI, 0.08-1.06), 6MWD (SMD = 0.56, 95% CI, 0.32-0.80), mMRC (SMD = -0.81, 95% CI, -1.23 to -0.40), Borg scale (SMD = -0.20, 95% CI, -0.39 to -0.02), SGRQ (WMD = -10.73, 95% CI, -15.80 to -5.65) and CAT (WMD = -3.75, 95% CI, -7.26 to -0.24). Improvement in FVC was not significant, and hospital admissions showed non-significant reduction (RR = 0.56, 95% CI, 0.28-1.10).

CONCLUSION

Pulmonary rehabilitation nursing was associated with improvements in exercise capacity, dyspnoea and health-related quality of life in patients with COPD, with additional benefits observed for selected pulmonary function measures.

RELEVANCE TO CLINICAL PRACTICE: Nursing roles should be explicitly integrated and reported within pulmonary rehabilitation pathways, particularly in patient education, symptom monitoring, inhaler technique reinforcement, adherence support, self-management counselling and follow-up care because nursing-inclusive rehabilitation models are associated with clinically meaningful improvements in exercise capacity, dyspnoea and quality-of-life.