The Effects of an Individualized Care Plan on Knowledge, Self-Care Behaviors, and Re-Admission Rate among Patients with Chronic Obstructive Pulmonary Disease

Abstract

Purposes: To compare the levels of knowledge and self-care behaviors among patients with COPD before and after receiving an individualized care plan; to compare hospital readmission rates between patients receiving the individualized care plan and those receiving usual care; and to evaluate patient satisfaction.

Study design: Quasi-experimental research using a Pretest–Posttest Two-Group Design.

Materials and Methods: The sample consisted of 62 COPD inpatients at Chondaen Hospital, divided into an experimental group (n=31) and a control group (n=31). The experimental group received an individualized care plan based on Orem's theory comprising individual assessment, tailored education and skill training, and two telephone follow-ups post-discharge.

Main findings: The experimental group showed statistically significant increases in overall knowledge scores (Mean diff. = 4.68, 95%CI: 4.24–5.12, < .001) and self-care behavior scores (Mean diff. = 22.94, 95%CI: 19.98–25.90, p < .001). The 30-day readmission rate was lower in the experimental group, although not statistically significant (3.23% vs 19.35%; Fisher's exact test, p = .104). The experimental group had significantly lower 30-day emergency department visits (9.68% vs 45.16%; OR = 0.13, 95%CI: 0.03–0.52, p = .002) and a significantly higher proportion of patients without exacerbations requiring treatment (87.10% vs 35.48%; OR = 12.27, 95%CI: 3.40–44.24, p < .001). Patient satisfaction was at a high level (Mean = 4.70 ± 0.32).

Conclusion and recommendations: The individualized care plan significantly improved COPD patients' knowledge and self-care behaviors, significantly reduced emergency department visits and exacerbations requiring treatment, and showed a trend toward reduced readmission rates. It is recommended as a standard practice for high-risk patients.