A Standardized Multicomponent Respiratory Guidance and Nursing Care Protocol for Elderly Patients with Chronic Obstructive Pulmonary Disease

Summary

This protocol describes a standardized, multicomponent respiratory guidance and nursing intervention incorporating breathing training, exercise, and supportive care to improve pulmonary function and functional outcomes in elderly patients with chronic obstructive pulmonary disease.

Abstract

This protocol describes a standardized, reproducible, multicomponent respiratory guidance and nursing care intervention for elderly patients with chronic obstructive pulmonary disease (COPD). Based on Orem’s self-care deficit nursing theory, the method integrates structured breathing training, respiratory muscle training, aerobic exercise, and continuous nursing support. The intervention is delivered by trained respiratory nurses over a 12-week period in inpatient and outpatient settings. The protocol includes procedures for patient selection, group allocation, baseline assessment, and structured implementation of intervention components. Breathing training incorporates guided respiratory exercises and spirometer-assisted techniques, combined with individualized exercise programs, psychological support, and discharge planning. The protocol specifies intervention frequency, duration, supervision, safety monitoring, and adherence tracking to ensure consistency and reproducibility. Standardized outcome assessment procedures are outlined, including pulmonary function testing, arterial blood gas analysis, dyspnea evaluation, functional ability assessment, sleep quality measurement, and quality-of-life evaluation using validated clinical instruments. This protocol provides a practical and structured framework for implementing nonpharmacological respiratory care in elderly patients with COPD across clinical and rehabilitation settings.

Introduction

Chronic obstructive pulmonary disease (COPD) is a common respiratory disorder in older adults¹. It encompasses chronic bronchitis and emphysema and is typically characterized by airflow limitation, shortness of breath, chronic dyspnea, cough, fatigue, chest tightness, weight loss, wheezing, and, in severe cases, respiratory failure². Major risk factors include tobacco smoking, exposure to indoor air pollution, and occupational pollutants³. The disease substantially impairs quality of life and is associated with high morbidity and mortality⁴. Diagnosis is based on characteri....

Protocol

Approval for this study was obtained from the Ethics Committee at Ningbo University. Obtain written informed consent from all participants or from their legal representatives, including close family members or caregivers where applicable.

1. Participant enrollment and ethical compliance

1. Submit the study protocol, intervention content, and potential risks to the institutional ethics committee of the implementing hospital.
2. Obtain ethical approval from the institutional ethics committee.
3. Provide full details of the protocol, intervention content, and potential risks to eligible patients and thei....

Results

Demographic characteristics

The study sample consisted of 135 elderly patients with COPD (Figure 3). They were divided into two groups according to the intervention received: a res. group (51.1% of cases) that received the respiratory guidance and nursing care protocol, and a con. group (48.9% of cases) that received routine care (Table 3). In the res. group, there were 45 men and 24 women, whereas in the con. group, there were 43 men and 23 w.......

Discussion

As a progressive respiratory disorder, COPD poses a substantial challenge to the health of elderly patients and remains a major focus and difficulty in clinical respiratory nursing practice¹. In this study, a standardized respiratory guidance and nursing care protocol was developed and implemented for elderly patients with COPD. We evaluated its effects on pulmonary function, ADL, dyspnea, sleep quality, and overall quality of life, while also establishing a set of structured and reproducible oper.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Activities of Daily Living (ADL) scale (https://www.wjx.cn/xz/247223917.aspx)	Changsha Ranxing Information Technology Co., Ltd.	N/A	Used to assess daily living capacity
Fully automated blood gas analyzer	Radiometer Medical ApS (Denmark)	ABL800 FLEX	Used for rapid measurement of arterial blood gas parameters, including pH, PaO2, PaCO2, and electrolytes
Modified British Medical Research Council (mMRC) dyspnea scale (https://www.wjx.cn/xz/228071123.aspx)	Changsha Ranxing Information Technology Co., Ltd.	N/A	Used to assess dyspnea severity
Pittsburgh Sleep Quality Index (PSQI) (https://www.wjx.cn/xz/343882592.aspx)	Changsha Ranxing Information Technology Co., Ltd.	N/A	Used to assess sleep quality
Pulse oximeter	Mindray Bio-Medical Electronics Co., Ltd. (China)	PM-60	Used to monitor oxygen saturation during training
Pulmonary function testing system (spirometer)	Mindray Bio-Medical Electronics Co., Ltd. (China)	MSA99	Used to measure FVC, FEV1, and FEV1/FVC
SPSS statistical analysis software	IBM	Version 22.0	Used for statistical analysis, including Shapiro–Wilk test, independent-samples t test, and Mann–Whitney U test
Three-ball spirometer (breathing trainer)	Shanghai Kanghua Medical Equipment Co., Ltd. (China)	KH-F100	Used for respiratory training
36-Item Short-Form Health Survey (SF-36) (https://www.wjx.cn/xz/96271644.aspx)	Changsha Ranxing Information Technology Co., Ltd.	N/A	Used to assess quality of life