TITLE OF THE STUDY

“Effect of nursing intervention programme on health status of patients with chronic obstructive
pulmonary disease’’

INTRODUCTION

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable  disease characterized
by slowly progressive persistent airflow limitation. COPD  encompassed two types of obstructive
airway diseases, chronic bronchitis and  emphysema, and these two diseases often coexist

COPD affects several organs and systems, and has a considerable impact on  health status.
Improvement of health status has become an important treatment goal in  COPD management
because low health status is known to be associated with increased  risk for re-admission to hospital
and increased mortality.

During the clinical experience,  the researcher observed that among patients with COPD, many were
readmitted with  exacerbation of COPD and found that these patients are not aware about the
benefits of  breathing exercises, importance of lifestyle modifications, and adherence to treatment 
and follow up.

Health education and breathing exercise improves multiple domains of health status such as fatigue,
dyspnea, emotional function, exercise ability and physical  activities. Hence the investigator felt a
great need to initiate a nursing intervention  programme to improve their health status. 

STATEMENT OF THE PROBLEM

A Study to Evaluate the Effect of Nursing Intervention Programme on Health  Status of patients with
Chronic Obstructive Pulmonary Disease, attending Govt. Medical College Hospital, Thrissur. 

OBJECTIVES

1.Determine the health status of patients with COPD. 

2. Find the effect of nursing intervention programme on health status of patients  with COPD. 

3. Analyse the association between health status of patients with COPD and  selected variables.

HYPOTHESIS 

H1 There is a significant difference in the mean scores of health status of patients with   COPD before
and after administration of nursing intervention programme 

H2 There is a significant difference in the mean scores of symptom state of health status  of patients
with COPD before and after administration of nursing intervention  programme

H3 There is a significant difference in the mean scores of functional state of health status   of patients
with COPD before and after administration of nursing intervention  programme 
H4 There is a significant difference in the mean scores of mental state of health status of   patients
with COPD before and after administration of nursing intervention programme 

H5 There is a significant association between health status of patients with COPD and  selected
variables 

MATERIALS AND METHODS

RESEARCH APPROACH

Quantitative approach

RESEARCH DESIGN

pre- experimental one group pre test post test design

SETTING OF THE STUDY

The study was conducted in Outpatient Department of Pulmonary Medicine,  Govt. Medical College
Hospital, Thrissur.

POPULATION AND SAMPLE SIZE

Population is the entire aggregation of the cases that meet a designated set of  criteria.In the
present study population selected was patients with COPD, attending  Govt. Medical College
Hospital, Thrissur.  

SAMPLING TECHNIQUE

Non probability purposive sampling technique

INCLUSION CRITERIA

Patients with Chronic Obstructive Pulmonary Disease who 

➢ has breathelessness grade between 0-2 as measured by mMRC dyspnoea scale  (modified
Medical Research Council Dyspnoea Scale). 

➢ are able to read and write Malayalam. 

➢ are willing to participate. 

EXCLUSION CRITERIA

Patients with COPD having co-morbidities other than Diabetes Mellitus and/or  Hypertension.

TOOL 1

socio-personal data sheet

Clinical data sheet

Technique: interview

TOOL 2

Modified clinical COPD questionnaire

Technique: self reporting technique

ANALYSIS

The study was conducted on pulmonology department of Govt. Medical College Hospital,   Thrissur.
Data collection period was from 16/1/2017 to 25/2/2017. Nursing intervention programme
including,  structured teaching on life style modifications, adherence to treatment and follow up 
related to COPD was given to a small group (3-5) for 20 minutes, after that scheduled   breathing
exercise was demonstrated which took 5 minutes.

Each patient was asked to redemonstrate it and correction was given in the technique as necessary.
A leaflet on the  same was given to each patient and he/she was asked to do exercise 2-3 minutes
three  times a day. After 6 weeks, post test was conducted using modified Clinical COPD  
Questionnaire. 

Section I: A. Socio personal data of patients with COPD

This section deals with socio personal data of patients with COPD which include age, gender, type of
family, education, occupation, marital status, and economic status of family.

Section I: B. Clinical data of patients with COPD This section deals the clinical data of patients with
COPD which includes duration of  illness, co-morbidities, management for COPD, alternative therapy
used, and history of  smoking. 

Section II 

This section deals with health status of patients with COPD. Health Status was assessed   by Modified
Clinical COPD Questionnaire, which is five point rating scale with 10  questions. The total score were
calculated by adding the scores of the ten items and  dividing that number by number of items (ten).
The maximum score was 4 which  indicates poor health status and minimum score was 0 indicating
good health status
Section III 

Effect of Nursing Intervention Programme on health status of patients with  Chronic Obstructive
Pulmonary Disease 

In order to evaluate the effect of nursing intervention programme on health status of  patients with
Chronic Obstructive Pulmonary Disease, paired t test was applied.

RESULTS
Section I: A. Description of socio personal data of patients with Chronic Obstructive Pulmonary
Disease

51.6% patients with COPD were in the age group of 61-70 years. Most of (93.8%) patients were
males. More than half of patients were hindhus. It was found that 70.3% of had primary education.
Majority of patients were married.
B. Description of clinical data of patients with Chronic Obstructive Pulmonary Disease

53.2% of patients had duration of illness between 1-5 years. 51.6% patients had no co-morbidities.
Majority of patients were on both oral medications and inhaler as a treatment. All male patients
(93.8%) had a history of habit of smoking.

Section II: Health status of patients with Chronic Obstructive Pulmonary Disease

Before nursing intervention programme none of the patients reported good health status and 57.8%
of the patients reported poor health status.

After nursing intervention programme nearly half(43.8%) of the patients reported good health status
and none of them reported poor health status.

Section III:Effect of nursing intervention programme on health status of patients  with COPD 

it is seen that the mean scores of symptom state of health status before  intervention was 3.1±0.41
and it was decreased to 1.8±0.50 after intervention. it  is interpreted that the nursing intervention
programme is effective in improving  symptom state of health status of patients
Section IV  :Association between health status of patients with COPD and selected variables

 
There was no significant association between health status of patients with COPD and selected
variables

CONCLUSION

Most of the patients with COPD were belonged to the age group of 61-70 years and were males.
None of the patients reported good health status before nursing intervention programme. After
intervention 43.8% of patients reported good health status. Nursing intervention programme was
effective in improving health status of patients with COPD.

DISSERTATION CRITIQUE

WRITING STYLE

The report is well written, concise, grammatically correct and there is no jargons.There was some
printing mistakes. It is well laid and organized and follows the sequence of steps in research process

AUTHOR CREDENTIALS

The researcher have the necessary knowledge and skills to do the research.

RESEARCH TITLE

Title is clear, accurate and unambiguous. It included all the variables under the study

ABSTRACT

Abstract offer a clear overview of the study including background, research problem, objective,
sample, methodology and discussion. The result and conclusion was not mentioned in the abstract.

RESEARCH PROBLEM

Problem is clearly stated with patient background information. The study purpose is clearly
identified. All the variables are mentioned and is found to be researchable.
REVIEW OF LITERATURE

It is clearly written and organized. Author have included most relevant and recent studies in review
of literature and are predominantly from primary sources and is empirical in nature. It also identifies
gap in the current knowledge and offers an unbiased analysis of available studies. It provides a basis
for the study conducted. Citations are provided accurately.

THEORETICAL FRAMEWORK

Conceptual framework of this study was developed based on Nola penderson’s health promotion
model. It is relevant and applicable to the research.

OBJECTIVES

Aims, objectives, research questions and research hypothesis and assumptions are identified and
clearly stated. Objectives are specific, measurable, reliable, relevant and time based.

VARIABLES

Variables of the study are clearly identified and operationally defined and is measurable

RESEARCH DESIGN

Research approach is clearly identified. The design is appropriate for the objectives and purpose of
the study and it infer the cause and effect relationship. Pilot study was conducted.

ETHICAL CONSIDERATION

Participants were well informed about the nature and purpose of the research and their
involvement was explained well and received informed consent. All the participants are protected
from harm.

SAMPLING

Sample is representative of the population. The target and accessible population are clearly
identified. The sampling method was appropriate. The author has not described any kind of bias

DATA COLLECTION

Data collection period was from 16/1/2017-25/2/2017. 60 patients diagnosed with COPD of
government medical college hospital Thrissur was selected. Pre test and post test was done using
socio demographic data sheet and modified clinical COPD questionnaire. The author has mentioned
Variable are measured using appropriate tools

MEASURMENTS

Reliability are tested. Data was collected under the same condition from all the subjects about the
duration of the interventional program.

DATA ANALYSIS AND RESULTS

The statistical procedure used was appropriate for the methodology and objectives. Sample
characteristics were described. The tables and graphs used are clear and labeled accordingly and the
findings are also adequately described in accordance with the hypothesis and objectives. Strength
and limitations are discussed

CONCLUSION
The author has given suggestions for the future research

REFERENCES

The author has mentioned all the referred books in the reference section by using Vancouver style

APPENDIX

The appendix is arranged in orderly format and the full text is available for the future reference.