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The purpose of this study is to provide nursing with data to explain variations in pulmonary functional status home care, discharge outcomes for patients with chronic obstructive pulmonary disease (COPD). A modified system's approach to measuring utilization and impact of home care services frames the proposed non-experimental, descriptive, comparative study. Patient characteristics will include age, gender, and measures of oxygen saturation, lung volumes, and psychological hardiness. Family characteristics will include the Family Mutual Aid Index and Family Coping Estimate. Home care nursing services will be measured by observation and records of number of identified (OMAHA) problems, number of interventions, and number of visits. Data will be collected from a convenience sample 92 patients with COPD on the second home care nursing visit, within one week of home care discharge and/or three months after discharge from the hospital. A group of twenty comparable patients who are discharged from the hospital without home care nursing will be studied prior to discharge and 3 months after hospital discharge. Data analysis will include descriptive statistics. Regression analysis will examine the predictors of patient and family characteristics on home care nursing services, as well as the effect of home care nursing services on pulmonary functional status. Discriminant analysis will be done to examine the effect of the same predictors on home care discharge status.
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