Volume 34, Issue 2 (Spring 2026)
Avicenna J Nurs Midwifery Care 2026, 34(2): 142-155 |
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Ethics code: IR.USWR.REC.1404.057
Clinical trials code: IRCT20160110025929N45
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Akbari A, Arsalani N, Naghikhani M, Hassaninia D, Vahedi M. Effect of Pulmonary Rehabilitation Nursing Interventions on Sleep Quality in Patients with Chronic Obstructive Pulmonary Disease: A Randomized Clinical Trial. Avicenna J Nurs Midwifery Care 2026; 34 (2) :142-155
URL: http://nmj.umsha.ac.ir/article-1-3433-en.html
URL: http://nmj.umsha.ac.ir/article-1-3433-en.html
1- Department of Nursing, Student Research Committee, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
2- Iranian Research Centre on Aging, Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran ,na.arsalani@uswr.ac.ir
3- Department of Basic Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
4- Department of Internal Medicine, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
5- Department of Biostatistics and Epidemiology, Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
2- Iranian Research Centre on Aging, Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran ,
3- Department of Basic Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
4- Department of Internal Medicine, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
5- Department of Biostatistics and Epidemiology, Pediatric Neurorehabilitation Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
Abstract: (789 Views)
Background and Objective: Chronic obstructive pulmonary disease (COPD) is associated with functional limitations as well as a high prevalence of sleep disturbances, which are linked to exacerbation of nocturnal symptoms, increased frequency of disease flare-ups, and reduced quality of life. Although pulmonary rehabilitation is recognized as an effective intervention for improving respiratory outcomes, sleep quality is often considered a secondary outcome. Moreover, the specific role of structured nursing interventions in its independent improvement has not been thoroughly evaluated. Therefore, this study aimed to determine the effect of nursing-based pulmonary rehabilitation interventions on sleep quality in patients with COPD.
Materials and Methods: This randomized controlled trial was conducted in 2025 on 32 hospitalized patients with COPD at Imam Reza Hospital, Kermanshah, Iran. Participants were randomly assigned to intervention and control groups using a block randomization method. Data collection tools included a demographic questionnaire and the Pittsburgh Sleep Quality Index (PSQI). The intervention group received a four-week combined (in-person and virtual) nursing pulmonary rehabilitation program, which included breathing techniques, activity-rest scheduling, fatigue management, sleep hygiene education, dietary recommendations, and proper medication adherence. The collected data were analyzed in SPSS software (version 26), applying independent t-tests, paired t-tests, and the Mann–Whitney test.
Results: The two groups were homogeneous in terms of demographic and clinical characteristics (p>0.05). After the intervention, the mean total PSQI score in the intervention group decreased significantly (Z=-3.517, p<0.001), whereas no significant change was observed in the control group (Z=-1.069, p=0.285). Subscale analysis indicated significant improvements in subjective sleep quality, sleep efficiency, sleep duration, and sleep latency in the intervention group, compared with the control group (t=-10.595, p=0.001).
Conclusion: The findings suggest that combined nursing interventions within the framework of pulmonary rehabilitation (in-person and virtual education) are associated with significant improvements in sleep quality in patients with COPD. These results support the potential role of structured nursing interventions in enhancing sleep-related outcomes and provide a foundation for further development and evaluation of this approach in future studies.
Materials and Methods: This randomized controlled trial was conducted in 2025 on 32 hospitalized patients with COPD at Imam Reza Hospital, Kermanshah, Iran. Participants were randomly assigned to intervention and control groups using a block randomization method. Data collection tools included a demographic questionnaire and the Pittsburgh Sleep Quality Index (PSQI). The intervention group received a four-week combined (in-person and virtual) nursing pulmonary rehabilitation program, which included breathing techniques, activity-rest scheduling, fatigue management, sleep hygiene education, dietary recommendations, and proper medication adherence. The collected data were analyzed in SPSS software (version 26), applying independent t-tests, paired t-tests, and the Mann–Whitney test.
Results: The two groups were homogeneous in terms of demographic and clinical characteristics (p>0.05). After the intervention, the mean total PSQI score in the intervention group decreased significantly (Z=-3.517, p<0.001), whereas no significant change was observed in the control group (Z=-1.069, p=0.285). Subscale analysis indicated significant improvements in subjective sleep quality, sleep efficiency, sleep duration, and sleep latency in the intervention group, compared with the control group (t=-10.595, p=0.001).
Conclusion: The findings suggest that combined nursing interventions within the framework of pulmonary rehabilitation (in-person and virtual education) are associated with significant improvements in sleep quality in patients with COPD. These results support the potential role of structured nursing interventions in enhancing sleep-related outcomes and provide a foundation for further development and evaluation of this approach in future studies.
Keywords: Chronic Obstructive Pulmonary Disease, Nursing Care, Pulmonary Rehabilitation, Sleep Quality
Type of Study: Original Research |
Subject:
Nursing
Received: 2025/12/2 | Accepted: 2026/04/27 | Published: 2026/05/31
Received: 2025/12/2 | Accepted: 2026/04/27 | Published: 2026/05/31
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