慢性阻塞性肺疾病患者护理医生管理模式的探讨及实践
发布时间：2018-08-05 12:32
【摘要】：目的:探讨慢性阻塞性肺疾病患者护理医生管理模式,拟定出工作方案,为COPD患者提供综合的、规范的、系统的个性化康复护理服务,探讨护理医生管理模式对COPD患者生活质量干预效果的影响。方法:结合我们国家现有的本地区医疗卫生资源,配合我国特有的医疗卫生体系,同时通过借鉴国外先进的临床护理医生管理模式、工作经验,制定护理医生的工作方案,并应用于COPD患者的康复护理过程中。从2013年3月----2013年8月在东阿县人民医院呼吸内科住院的COPD患者中选择80例患者,采取随机分组的方法,将其分为对照组和干预组。干预组患者在住院期间临床护理医生对其实施康复护理及健康指导,在出院后进行随访并跟踪指导,对照组患者采用以往呼吸系统疾病护理常规进行护理、治疗。出院后对对照组、干预组患者均观察随访半年。分别监测并评价两组患者入院时、出院时、出院后三个月及六个月时的肺功能检查、生存质量(SGRQ)、运动耐力(BODE指数)、患者满意度、出院六个月内的平均医疗费、平均住院日、再次入院率等评价指标,懫用SPSS 17.0软件包对数据进行分析处理,(P0.05)是有显著性差异的判断标准。结果:1.对两组患者入院时一般性资料、肺功能的检查指标、SGRQ评分、BODE指数进行比较(P0.05),差异均无统计学意义。2.患者出院时各项指标的比较:干预组患者的肺功能指标明显高于对照组(P0.05);对SGRQ评分结果进行比较,对照组病人的SGRQ总分及其组成部分(症状分、活动分、影响分)得分均高于干预组(P0.05);在BODE指数结果比较中,除了BIM指数(P0.05)外,其它指标都具有统计学意义(P0.05);在患者满意度调查的各项指标中干预组明显优于对照组,具有统计学意义(P0.05)。3、出院三个月及六个月时各评价指标的比较结果:干预组患者的肺功能指标明显高于对照组(P0.05);在SGRQ比较中,干预组患者SGRQ总分及各组成部分得分均低于同级对照组(P0.05);在BODE指数结果比较中,干预组各项指标明显优于对照组,具有统计学意义(P0.05);在患者满意度调查的各项指标中干预组明显优于对照组,具有统计学意义(P0.05)。干预组患者自入院至出院六个月内的平均医疗费、平均住院日及再次入院率均低于对照组(P0.05),具有统计学意义。结论:通过护理医生指导下的肺康复教育对慢性阻塞性肺疾病患者肺功能、SGRQ评分、BODE指数的影响,能有效减轻COPD患者的呼吸困难症状、增强活动耐力、改善营养状况、有效提高了患者的满意度和生活质量,同时降低了患者平均医疗费、平均住院日、再次入院率。
[Abstract]:Objective: to explore the management mode of nursing doctors in patients with chronic obstructive pulmonary disease (COPD) and to draw up a working plan to provide comprehensive, standardized and systematic individualized rehabilitation nursing services for patients with COPD. To explore the effect of nursing doctor management mode on quality of life (QOL) intervention in patients with COPD. Methods: according to the existing medical and health resources of our country and the special medical and health system of our country, and by drawing lessons from the advanced management mode and working experience of clinical nursing doctors from abroad, we worked out the working plan of nursing doctors. And applied to the rehabilitation nursing process of COPD patients. From March 2013 to August 2013, 80 COPD patients were selected from Department of Respiratory Medicine, Donga County people's Hospital, and were randomly divided into control group and intervention group. The patients in the intervention group were given rehabilitation nursing and health guidance during hospitalization, followed up and followed up after discharge, while the patients in the control group were treated with routine nursing for respiratory diseases. The patients in the control group and the intervention group were followed up for half a year after discharge. Pulmonary function tests, quality of life (SGRQ),) exercise endurance (BODE index), patient satisfaction, average medical expenses within 6 months, average hospitalization days were monitored and evaluated at admission, 3 months and 6 months after discharge. The re-admission rate and other evaluation indexes were analyzed and processed by SPSS 17.0 software package. (P0.05) was the criterion of significant difference. The result is 1: 1. Two groups of patients on admission to the general data, pulmonary function test index of SGRQ scores and BODE index were compared (P0.05), the difference was not statistically significant. 2. Comparison of the indexes at discharge: the pulmonary function of the patients in the intervention group was significantly higher than that in the control group (P0.05); the total score of SGRQ and its components in the control group were compared with those in the control group (symptom score, activity score, P05). Impact scores were higher than the intervention group (P0.05); in the comparison of BODE index results, in addition to the BIM index (P0.05), other indicators were statistically significant (P0.05); in the patient satisfaction survey of the indicators of the intervention group was significantly better than the control group, There was statistical significance (P0.05) .3. the comparison of the evaluation indexes at 3 months and 6 months after discharge: the pulmonary function index of the intervention group was significantly higher than that of the control group (P0.05); in the comparison of SGRQ, the lung function index of the intervention group was significantly higher than that of the control group (P0.05). The total score of SGRQ and the scores of each component in the intervention group were lower than those in the control group (P0.05); in the comparison of the results of BODE index, the indexes of the intervention group were significantly better than those of the control group. There was statistical significance (P0.05); the intervention group was significantly better than the control group in the indicators of patient satisfaction survey (P0.05). The average medical expenses, average hospitalization days and readmission rate in the intervention group were lower than those in the control group (P0.05). Conclusion: the effect of pulmonary rehabilitation education under the guidance of nursing doctors on the pulmonary function and SGRQ score and bode index of patients with chronic obstructive pulmonary disease can effectively alleviate the symptoms of dyspnea, enhance activity tolerance and improve nutritional status in patients with COPD. It can effectively improve patients' satisfaction and quality of life, at the same time reduce patients' average medical expenses, average hospitalization days, and readmission rate.
【学位授予单位】：泰山医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R473.5
本文编号：2165808
[Abstract]:Objective: to explore the management mode of nursing doctors in patients with chronic obstructive pulmonary disease (COPD) and to draw up a working plan to provide comprehensive, standardized and systematic individualized rehabilitation nursing services for patients with COPD. To explore the effect of nursing doctor management mode on quality of life (QOL) intervention in patients with COPD. Methods: according to the existing medical and health resources of our country and the special medical and health system of our country, and by drawing lessons from the advanced management mode and working experience of clinical nursing doctors from abroad, we worked out the working plan of nursing doctors. And applied to the rehabilitation nursing process of COPD patients. From March 2013 to August 2013, 80 COPD patients were selected from Department of Respiratory Medicine, Donga County people's Hospital, and were randomly divided into control group and intervention group. The patients in the intervention group were given rehabilitation nursing and health guidance during hospitalization, followed up and followed up after discharge, while the patients in the control group were treated with routine nursing for respiratory diseases. The patients in the control group and the intervention group were followed up for half a year after discharge. Pulmonary function tests, quality of life (SGRQ),) exercise endurance (BODE index), patient satisfaction, average medical expenses within 6 months, average hospitalization days were monitored and evaluated at admission, 3 months and 6 months after discharge. The re-admission rate and other evaluation indexes were analyzed and processed by SPSS 17.0 software package. (P0.05) was the criterion of significant difference. The result is 1: 1. Two groups of patients on admission to the general data, pulmonary function test index of SGRQ scores and BODE index were compared (P0.05), the difference was not statistically significant. 2. Comparison of the indexes at discharge: the pulmonary function of the patients in the intervention group was significantly higher than that in the control group (P0.05); the total score of SGRQ and its components in the control group were compared with those in the control group (symptom score, activity score, P05). Impact scores were higher than the intervention group (P0.05); in the comparison of BODE index results, in addition to the BIM index (P0.05), other indicators were statistically significant (P0.05); in the patient satisfaction survey of the indicators of the intervention group was significantly better than the control group, There was statistical significance (P0.05) .3. the comparison of the evaluation indexes at 3 months and 6 months after discharge: the pulmonary function index of the intervention group was significantly higher than that of the control group (P0.05); in the comparison of SGRQ, the lung function index of the intervention group was significantly higher than that of the control group (P0.05). The total score of SGRQ and the scores of each component in the intervention group were lower than those in the control group (P0.05); in the comparison of the results of BODE index, the indexes of the intervention group were significantly better than those of the control group. There was statistical significance (P0.05); the intervention group was significantly better than the control group in the indicators of patient satisfaction survey (P0.05). The average medical expenses, average hospitalization days and readmission rate in the intervention group were lower than those in the control group (P0.05). Conclusion: the effect of pulmonary rehabilitation education under the guidance of nursing doctors on the pulmonary function and SGRQ score and bode index of patients with chronic obstructive pulmonary disease can effectively alleviate the symptoms of dyspnea, enhance activity tolerance and improve nutritional status in patients with COPD. It can effectively improve patients' satisfaction and quality of life, at the same time reduce patients' average medical expenses, average hospitalization days, and readmission rate.
【学位授予单位】：泰山医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R473.5
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