ArticleHealthcare (Basel, Switzerland)2026
Effects of a Nurse-Coordinated Transitional Care Service on Self-Management, Functional Status, Psychological, and Patient-Centered Outcomes in Patients with COPD: A Randomized Controlled Trial.
Article in Healthcare (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTransitioning from hospital to home presents substantial challenges for patients with chronic obstructive pulmonary disease (COPD), often leading to difficulties maintaining self-management, functional independence, and psychological well-being after discharge. Although transitional care programs are increasingly implemented, their effects on multidimensional patient-centered outcomes remain insufficiently examined. This study aimed to evaluate the effectiveness of a nurse-coordinated transitional care service for patients with COPD during the transition from hospital to home and to examine its broader implications for improving continuity of care and patient-centered outcomes within the healthcare system.
methodsThis randomized controlled trial was conducted in three university hospitals in South Korea between November 2022 and December 2024. A total of 465 patients were randomly assigned to either a nurse-coordinated transitional care intervention group or a usual care group. The intervention included structured self-management education during hospitalization, post-discharge home visits, and follow-up telephone consultations during the first month after discharge. Outcomes were assessed at baseline, 1 month, and 3 months. Statistical analyses included linear mixed-effects models for continuous outcomes and chi-square tests and independent t-tests for group comparisons.
resultsPatients in the Transitional Care Group (TCG) showed marked improvements: disease awareness increased from 27.9% to 94.3% (vs. 35.7% in the Usual Care Group [UCG], RR = 2.64, 95% CI: 2.19-3.18,
conclusionsThese findings indicate that nurse-coordinated transitional care enhances patients' self-management capacity and improves patient-centered outcomes during the transition from hospital to home.
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