第廿八次護理研究論文發表會暨兩岸護理學術交流The Comparative Efficacies of Airway Clearance Techniques and Pursed-Lip

Breathing in Hospitalized Patients With Acute COPD ExacerbationLin-Yu Laio1, Kuei-Min Chen2, Jung-Yien Chien3

Chest Hospital, Department of Health Executive Yuan1,3 Ph.D. Student, Kaohsiung Medical University 1

Professor, Kaohsiung Medical University 2

Background： The role of respiratory tract cleansing and pursed-lip breathing in patients with COPD AE is still on clear.Purpose: Acute exacerbation of COPD, potentially due to gas change, often increases mucus production and dyspnea (Burge & Wedzicha, 2003). Airway clearance techniques and pursed-lip breathing have been used to help reduce sputum and improve dyspnea in patients with COPD AE. This study tested the effects of airway clearance techniques and pursed-lip breathing rehabilitation program in patients with COPD AE.

Table 1. Demographic profiles N=53

Table 2. Dyspnea Scales AnalysisTime M±SD t p

Admitted 1stand 2rd 　 3.92 .001***

Admitted 1st 4.45±3.33 　 　Admitted 2nd 3.38±3.11 　 　

Admitted 1stand 3rd 　 5.90 .001***

Admitted 1st 4.45±3.33 　 　Admitted 3rd 2.43±2.58 　 　

Admitted 1stand 4th 　 7.31 .001***

Admitted 1st 4.45±3.33 　 　Admitted 4th 1.70±1.97 　 　

Admitted 2rdand 3rd 　 4.203 .001***

Admitted 2nd 3.38±3.11 　 　Admitted 3rd 2.43±2.58 　 　

Admitted 2rdand 4th 　 5.54 .001***

Admitted 2nd 3.38±3.11 　 　Admitted 4th 1.70±1.97 　 　

Admitted 3rdand 4th 　 4.67 .001***

Admitted 3rd 2.43±2.58 　 　Admitted 4th 1.70±1.97 　 　

Variable M±SD n(%) Variable n(%)Age 66.53±10.18 　 Education 　High 159.45±7.69 　 NO 15(28.3%)

Body Weight 58.83±10.62 　 Primary school 27(50.90%)BMI 23.25±4.00 　 Junior school 10(18.90%)

Peak flow 132.08±62.78 　 High school 1(1.9%)Sex 　 　 Chronic diease 　

Male 　 35(66.00%) NO 8(15.1%)Femal 　 18(34.00%) Yes 45(84.9%)

Marry 　 　 Smoking 　No 　 35(66.00%) No

32(60.4%)

Yes 　 18(34.00%) Yes21(39.6%

)

Methods: A pre-test and post-test quasi-experimental design was applied; A convenience sample of 53 patients with acute exacerbation of COPD was recruited from a chest hospital in southern Taiwan; Airway clearance techniques and pursed-lip breathing were applied 30 minutes per time on the first day of admission (baseline) and on the 2nd, 3rd, and 4th days (post-tests); Sputum and dyspnea score were measured to measure intervention efficacy (Wu, 2008)

Table3 Sputum Scales Analysis Time M±SD t p

Admitted 1stand 2rd 　 -1.798 0.078Admitted 1st 1.00±0.81 　 　Admitted 2nd 1.21±0.69 　 　

Admitted 1stand 3rd 　 3.346 0.002Admitted 1st 1.00±0.81 　 　Admitted 3rd 1.49±0.64 　 　

Admitted 1stand 4th 　 3.876 0.00 Admitted 1st 1.00±0.81 　 　Admitted 4th 1.53±S0.58 　 　

Admitted 2rdand 3rd 　 2.986 0.004Admitted 2nd 1.21±0.69 　 　Admitted 3rd 1.49±0.64 　 　

Admitted 2rdand 4th 　 2.907 0.005Admitted 2nd 1.21±0.69 　 　Admitted 4th 1.53±S0.58 　 　

Admitted 3rdand 4th 　 0.468 0.642Admitted 3rd 1.49±0.64 　 　Admitted 4th 1.53±S0.58 　 　

Implication for Practice: Airway clearance techniques and pursed-lip breathing improve sputum clearance and decrease dyspnea. This article provides guidance to nurses responsible for treating inpatients with acute COPD exacerbationKey Words: Airway Clearance Techniques, Pursed-Lip Breathing, Chronic Obstructive Pulmonary Disease