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

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.

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.

Systematic review and meta-analysis.

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).

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).

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.

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.