Nurses’ intervention in the Promotion of Self-care in People with COPD: a Systematic Review of the Literature

The Chronic Obstructive Pulmonary Disease (COPD) is, according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD, 2017), a common disease that can be prevented, characterized by persistent respiratory symptoms and limitation of the air flow, resulting of alveolar alterations and/or of the airways, caused by significant exposure to particles or harmful gases. The dyspnea is the main symptom and which the dyspnea spiral leads the person to reduce or avoid physical activity, leading to physical decondition (Cordeiro & Menoita, 2012). That way, the COPD compromises the well-being and self-care, limitating the person in their ability to partake in their social and family life. This study has a goal to systemize nursing interventions that promotes the person with COPD’s self-care according to the Self-Care Theory of Orem. The methodology used was the systematic revision of literature. The starting question respects the criteria of the PICO format (Melnyk & Fineout-Overholt, 2005): When it comes to the person with CPOC (Population) which are the nursing interventions that promote self-care (Outcome)? It was accomplished a research with electronic data bases, in the EBSCO in general, in CINAHL and MEDLIN in particular. The Boolean descriptors and operators were used with the following orientation: [Nurs* AND (Lung Diseases, Obstructive OR Pulmonary Disease, Chronic Obstructive OR COPD) AND (Self Care OR Activities of Daily Living) AND (Adult OR Aged OR Aged, 80 and over)]. To select the articles, it was defined inclusion and exclusion criteria. We included articles referring nursing interventions that promote self-care in adults and elderly patients with COPD. Articles with unclear methodology, without correlation with the object of study, repeated in the different data bases, written in non - English and non - Portuguese language, not available in full text and published before 2008, were not included. After applied the filtration method, seven articles were selected. In their analyses it came to surface the following nursing interventions that promote self-care: breathing exercises, physical exercise (Casey et al., 2011 e Isselt et al.,2014) and health education. In the health education it stands out the management of symptoms such as dyspnea (Titova et al., 2015; Billington et al., 2015). For the symptomatic and exacerbations control is crucial the instruction of energy saving techniques (Cosgrove et al., 2013), rest and relaxation techniques (Isselt et al., 2014), bronchial hygiene (Cosgrove et al., 2013), and management of the therapeutical regiment (Trappenburg et al., 2009; Casey et al., 2011; Titova et al., 2015; Billington et al., 2015), specially inhalation and oxygen therapy. It is also crutial the education about adopting healthy lifestyles, such as eating habits, (Isselt et al., 2014), smoking cessation (Trappenburg et al., 2009; Cosgrove at al.2013) and physical exercise (Nguyen et al.,2008). The nurse, in the extent of their skills, promotes the self-care in the person with DPOC, helping them overcome the changes and reducing the self-care needs.