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Effectiveness of teaching in the rehabilitation of patients with chronic bronchitis and emphysema Perry, JoAnn

Abstract

This study concerned itself with planned teaching, based on principles of adult education, as a component of the rehabilitation of patients with chronic bronchitis and emphysema. The need for teaching in this area has been recognized, but as yet not researched. The purpose of this study was to determine whether the teaching intervention, conducted in groups and on a one-to-one basis, would affect the patient's ability to recognize and treat his disease symptoms. The null hypothesis was tested: there is no significant difference in the patient's ability to recognize and treat disease symptoms after he has participated in a teaching program as compared to his ability to recognize and treat disease symptoms before participating in such a program. Using two rehabilitation facilities in large metropolitan hospitals, all patients accepted for the rehabilitation programs over a four-month period were asked to participate in the study. Ultimately, twenty patients made up the study group. Patients were instructed in diary-keeping skills and given one diary per week for four weeks before they began the rehabilitation program. These diaries were reviewed on a weekly basis with the researcher. After the patients had participated in the teaching program they were again given diaries (one per week for eight weeks) which were reviewed weekly with the researcher. The patients were asked to describe each day as being a good (comfortable) day or a bad (uncomfortable) day, to record the presence of any symptoms that they experienced, and to record any activities or treatments that they used to make themselves more comfortable. Twelve symptoms and eleven treatments were under consideration. The symptoms and treatments were divided into before and after categories and analyzed using the t ratio for non-independent groups. The results of the analysis lead to the rejection of the null hypothesis with p=0.05, indicating that patients with chronic bronchitis and emphysema were better able to cope with their illnesses after the teaching intervention. The study recommends that health care facilities establish teaching programs for patients with these illnesses, and that nurses assume greater involvement and responsiblity for teaching patients. The study concludes with recommendations for further investigation.

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