Nurse-Led Peer Support Proves Effective at Improving Lung Function, QOL in COPD

Peer support interventions that included nursing staff was found to effectively improve lung function and quality of life of nonsmoking patients with chronic obstructive pulmonary disease (COPD), according to a recent study published in the Canadian Respiratory Journal.

The study highlighted how the professional knowledge and communication skills that nurses possess can provide psychological comfort and encouragement to nonsmoking patients. Nurses can also use their knowledge and skills to guide patients to help them better manage their COPD.

“Peer-support nursing can not only effectively make nonsmoking patients feel positive energy such as respect and trust but also enable nonsmoking patients to get guidance from medical staff in the community, so as to promote the establishment and maintenance of their healthy lifestyle,” wrote the investigators.

Use of long-acting maintenance bronchodilators, inhaled corticosteroids, and pulmonary rehabilitation can decrease symptoms, reduce exacerbation frequency, and improve pulmonary function. However, few actions beyond these therapeutic methods have been taken to reduce disease progression or mortality rates.

Peer support generally involves nonprofessionals who have similar diseases or experience with disease management. If conducted effectively, patients can benefit from disease management assistance, links to clinical care, and social and emotional support that is available at all times.

The investigators enrolled 100 nonsmoking patients with COPD who were admitted at the Human Provincial People’s Hospital in Changsha, China between October 2018 and October 2020. The patients were split into a control group (n = 50), where they were treated with routine care, and an observation group (n = 50), where the patients received routine care and peer support nursing.

The observation and control groups had a mean (SD) age of 45.36 (15.68) years and 46.25 (14.65) years, respectively. Both groups had a higher number of male than female patients (observation group, n = 28 vs 22; control group; n = 27 vs 23).

Before the study, the researchers recruited nurses and peers to interact with the patients. Nurses had to have at least a bachelor degree and more than 5 years of experience working in a respiratory department, at least 3 of which they had to be working as a senior nurse.

The observation group were given health education training through group interaction and situational dialogue. Peers functioned as group leaders to demonstrate pulmonary function exercises and share rehabilitation knowledge. Patients were added to a peer support group chat, where disease rehabilitation knowledge and psychological counseling were provided.

The groups were evaluated before the intervention and 3 months after the interventions. The patients were given a social support rating scale featuring a 5-point Likert scale. When tallied, the scored demonstrated the impact that the intervention had on patient lifestyle. The higher the score, the more improved the lifestyle.

Prior to the intervention, the groups did not differ much in values depicting subjective support, objective support, utilization of support, and total scores (P > .05). However, scores for subjective support and support utilization were significantly higher in the observation group compared with the control group 3 months after receiving the intervention (P < .05).

The groups also did not have significant different in scores for positive attitude, stress reduction, self-decision making, and total score prior to the intervention (P > .05). Three months after the intervention, the values shifted to be significantly higher in the observation group than the control group (P < .05).

There were also no differences prior to the intervention between the groups regarding health responsibility, self-realization, interpersonal support, and stress management (P > .05), but the observation group had significantly higher scores than the control group for these values after the intervention (P < .05).

After the intervention, the observation group performed better during the 6-minute walk test than the control group (P < .05). Before the intervention, both groups performed similarly (P > .05).

A limitation of the study was that the investigators did not look at the potential impact that family cooperation in nursing could have on the results. The investigators said that follow-up studies need to be conducted and should focus on formulating relevant intervention programs.

Reference

Yao X, Wang X, Tuan J, Huang Z, Wu D, Xu H. Benefits conferred by peer-support nursing intervention to pulmonary function and quality of life in nonsmoking patients with COPD. Can Respir J. Published online June 16, 2021. doi: 10.1155/2021/7450979