A Standardized Multicomponent Respiratory Guidance and Nursing Care Protocol for Elderly Patients with Chronic Obstructive Pulmonary Disease.

This protocol describes a standardized, reproducible, multicomponent respiratory guidance and nursing care intervention for elderly patients with chronic obstructive pulmonary disease (COPD). Based on Orem's self-care deficit nursing theory, the method integrates structured breathing training, respiratory muscle training, aerobic exercise, and continuous nursing support. The intervention is delivered by trained respiratory nurses over a 12-week period in inpatient and outpatient settings. The protocol includes procedures for patient selection, group allocation, baseline assessment, and structured implementation of intervention components. Breathing training incorporates guided respiratory exercises and spirometer-assisted techniques, combined with individualized exercise programs, psychological support, and discharge planning. The protocol specifies intervention frequency, duration, supervision, safety monitoring, and adherence tracking to ensure consistency and reproducibility. Standardized outcome assessment procedures are outlined, including pulmonary function testing, arterial blood gas analysis, dyspnea evaluation, functional ability assessment, sleep quality measurement, and quality-of-life evaluation using validated clinical instruments. This protocol provides a practical and structured framework for implementing nonpharmacological respiratory care in elderly patients with COPD across clinical and rehabilitation settings.