Effectiveness of an Internet-Based 4C Nursing Model on Pulmonary Rehabilitation Outcomes in Patients with Chronic Obstructive Pulmonary Disease: A Quasi-Experimental Study.
Purpose: Pulmonary rehabilitation (PR) adherence in patients with chronic obstructive pulmonary disease (COPD) declines markedly after hospital discharge, underscoring the need for theory-driven, continuous care models. The 4C nursing model—integrating Comprehensiveness, Collaboration, Coordination,...
| Publicado en: | Patient Preference & Adherence Vol. 20; pp. 1 - 14 |
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| Autores principales: | , , , |
| Formato: | clinical trial research tables/charts Journal Article |
| Publicado: |
Dove Medical Press Ltd
Jun2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=195548478&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 195548478 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 1177889X B06U jtl: Patient Preference & Adherence issn: 1177889X maglogo: N pubinfo: dt: Jun2026 vid: 20 pid: 45064 pub: Dove Medical Press Ltd place: Auckland, <Blank> artinfo: ui: 195548478 195548478 195548478 10.2147/PPA.S609086 195548478 ppf: 1 ppct: 13 formats: tig: atl: Effectiveness of an Internet-Based 4C Nursing Model on Pulmonary Rehabilitation Outcomes in Patients with Chronic Obstructive Pulmonary Disease: A Quasi-Experimental Study. aug: au: Shen, Fufen Guo, Zhankun Zhang, Zhifen Zhou, Hui sug: subj: Severity of Illness Pulmonary Disease, Chronic Obstructive Rehabilitation Pulmonary Disease, Chronic Obstructive Nursing Rehabilitation, Pulmonary Telerehabilitation Internet-Based Intervention Nursing Models, Theoretical Health Knowledge Evaluation Self-Efficacy Evaluation Patient Compliance Evaluation Forced Expiratory Volume Evaluation Quality of Life Evaluation Pulmonary Disease, Chronic Obstructive Education Nursing Care Methods Human Quasi-Experimental Studies Nonequivalent Control Group Clinical Trials Rehabilitation Centers Rehabilitation Patients China Prospective Studies Inpatients Teaching Materials After Care Self Report Questionnaires Scales Respiratory Function Tests Male Female Middle Age Aged Funding Source Continuity of Patient Care Collaboration Patient Centered Care Pretest-Posttest Control Group Design Holistic Care Individualized Medicine Multidisciplinary Care Team Nurse-Patient Relations Professional-Family Relations Ambulatory Care Data Analysis Software Nursing Outcomes Fisher's Exact Test Unpaired T-Tests Repeated Measures Analysis of Variance Post Hoc Analysis Confidence Intervals Descriptive Statistics Chi Square Test Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Purpose: Pulmonary rehabilitation (PR) adherence in patients with chronic obstructive pulmonary disease (COPD) declines markedly after hospital discharge, underscoring the need for theory-driven, continuous care models. The 4C nursing model—integrating Comprehensiveness, Collaboration, Coordination, and Continuity—provides a structured, patient-centered framework that may simultaneously address multiple adherence barriers when delivered via internet-based platforms. This study evaluated the effectiveness of this integrated approach for COPD pulmonary rehabilitation. Patients and Methods: A quasi-experimental study was conducted at Baoding Rehabilitation Hospital (January–December 2024). Ninety-four patients with COPD (GOLD stages II–III) were allocated sequentially to a control group (n = 47; conventional nursing care) or an intervention group (n = 47; internet-based 4C nursing model). Primary outcomes were COPD knowledge scores and PR adherence; secondary outcomes included the COPD Self-Efficacy Scale (CSES), FEV1% predicted, and the COPD Assessment Test (CAT). Outcomes were assessed at baseline, 3 months, and 6 months. Results: Baseline characteristics were comparable between groups (all P > 0.05). At 6 months, the intervention group showed significantly greater improvements in COPD knowledge (mean difference 8.55; 95% CI 7.27– 9.83; Cohen's d = 2.70), self-efficacy (mean difference 15.48; 95% CI 12.25– 18.71; d = 1.94), and PR adherence (mean difference 0.74; 95% CI 0.50– 0.97; d = 1.27), alongside significant improvements in FEV1% predicted (P = 0.005; d = 0.77) and CAT scores (P < 0.001; d = 1.39). Conclusion: This single-center quasi-experimental study found that an internet-based 4C nursing model was associated with clinically meaningful improvements across multiple COPD outcomes over 6 months. These preliminary findings support the feasibility of theory-driven, telehealth-enhanced nursing care and warrant confirmation through multicenter randomized trials. pubtype: Academic Journal doctype: clinical trial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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