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Patients with chronic obstructive pulmonary disease (COPD) suffer many physical disabilities which cause many problems in their life. These patients really need to have continuity of care based on cooperation between patient, the family and their care givers in order to achieve an integration of care. The purpose of this paper is to assess the impact of continuous care on quality of life of patients with COPD.

A before–after quasi-experimental study was carried out with 72 patients with COPD at Beheshti educational hospital of Hamadan University of Medical Sciences. The patients who met inclusion criteria were randomly allocated into an intervention group (n=36) and a control group (n=36). The patients completed the St George’s Respiratory Questionnaire before and after their care. The intervention comprised continuous care with orientation and sensitization sessions (2 weeks), control and evaluation sessions (45 days) for intervention group and with routine care in the control group. Data were analyzed with SPSS, descriptive and inferential statistics were conducted to measure differences between intervention and control group.

Continuity of care improved significantly the quality of life of COPD patients in general, and in the symptoms, activity and impact domains (P=0.001). In contrast, routine care did not improve quality of life for patients in general, and in the symptoms, activity and impact domains (P=0.05).

Continuity of care has a positive impact on quality of life for COPD patients. Health care system should utilize continuity of care models as an overall plan for patients with COPD. Moreover, managers of health care system could reduce burden of chronic diseases by employing continuity of care models in planning patient care.

To reduce financial and human losses, managing risks associated with earthquakes is essential in practice. However, in using common risk management methods, experts are often faced with ambiguities that can create profound challenges for risk management. Therefore, it is necessary to develop a logical and straightforward risk assessment model to provide scientific and accurate answers to complex problems. This study aims to recommend an innovative combined method based on the probability-impact (P-I) approach and intuitionistic fuzzy set theory to identify and prioritize the essential earthquake risks associated with worn-out urban fabrics in the context of Iran.

The opinions of 15 experts in the fields of civil engineering and urban construction were gathered during brainstorming sessions. These brainstorming sessions were conducted to determine the probability of risks and the effect of identified risks. After calculating the severity of risks using the P-I approach and converting them to intuitionistic fuzzy sets, the risks were measured and prioritized based on their individual scores.

The study results indicated that risk of damage due to buildings’ age and flooding risk had the highest and lowest priorities in causes of financial damage, respectively. Furthermore, the risk of damage due to building quality (demolition) and building age was the most important. The risk of flooding and damage to communication networks has the lowest importance among causes of fatalities in worn-out urban fabrics.

The study findings and recommendations can be served as a policy and consultative instrument for the relevant stakeholders in the area of urban management.