Characteristics of Visiting Nursing Stations Having Patients with exacerbated Chronic Obstructive Pulmonary Disease

Abstract

Background & Aims: This study aimed to clarify the background characteristics of visiting nursing stations (STs) providing home care for chronic obstructive pulmonary disease (COPD) patients who had an exacerbation during the past 6 months, as well how they dealt with early detection, responding to exacerbations, and end-of-life treatment.

Methods: A survey was conducted by mailing a questionnaire to 2,000 STs nationwide. The survey items included the organizational background of the STs, exacerbation history, and background of patients with recuperating COPD, the response of STs, and concerns regarding visiting nurses.

Results: The analysis included 301 facilities (24.1％) providing home care for COPD patients during the survey period. Notably, STs (n＝142) with patients who suffered exacerbations provided services for a high number of patients with COPD, noninvasive positive pressure ventilation (NPPV) users, individuals with modified Medical Research Council Dyspnea Scale (mMRC) (Grades 3 and 4), and people living alone. These facilities also created action plans, employed multidisciplinary collaboration, and confirmed whether or not the recuperating COPD patients desired end-of-life treatment (p<0.05).

Conclusions: STs with COPD patients who experienced exacerbations served COPD patients with greater disease severity and employed various response strategies to the onset of exacerbations.