优质护理延伸服务在COPD患者居家护理中的开展及研究
发布时间：2018-11-28 13:21
【摘要】：目的本研究是针对昆山市第六人民医院呼吸内科COPD患者出院后的疾病认知情况和延伸服务需求进行调查和临床分析,结合奥瑞姆自我护理理论和健康促进模式探索并制定适用本辖区COPD患者经住院治疗病情稳定出院后延续护理措施和居家护理干预方式,达到提高稳定期COPD患者健康自我护理能力,提高这一人群的生活质量,减少疾病复发,降低再住院率的目的方法本研究分为两个部分,第一部分在参阅文献和请专家指导的基础上设计调查问卷,筛选病例对COPD患者出院后疾病认知情况和社区延伸服务需求调查,分析总结并制定出相应的优质护理延伸服务措施。第二部分结合优质护理延伸服务理念,以奥瑞姆自我护理理论为指导,根据本辖区COPD出院患者的特点按照护理程序制定适宜居家护理干预方式,并组织开展实施和效果评价。结果①COPD患者疾病认知情况和延伸服务需求调查结果：本辖区COPD患者以老年人居多,文化程度普遍较低,且住在乡下农村居多,出行和行动均不方便、记忆力减退接受能力差、自理能力下降及子女工作繁忙而对老人无暇顾及等诸多问题而导致此类人群疾病认知低,了解自身病情的治疗措施和掌握功能锻炼方法分别为29.2%、17.5%；延伸服务需求调查前三位：用药指导占94.2%、营养饮食占79.2%、功能锻炼指导占72.5%。②优质护理延伸服务干预结果：两组患者出院时和出院后3个月6MWT测试结果对比无明显差异(P0.05),但6个月的结果对比的差异有统计学意义(P0.05)；两组患者在出院时和出院后3个月呼吸困难程度(MMRC)结果差异不明显(P0.05),到出院后6个月的呼吸困难评分要显著低于对照组(P＜0.05)；两组患者出院时和出院后3个月中文版呼吸问卷调查(CAT)情况对比无明显差异(P0.05),但6个月的CAT调查结果对比的差异有统计学意义(P0.05)；两组COPD患者在出院后6个月内的加重次数的差异和复发率的差别均有统计学意义(P0.05)。结论①COPD患者优质护理延伸服务措施的关键是以通俗易懂的方式普及疾病相关知识,已规范的流程保持定期随访,结合评估需求设计并计划护理活动,从而帮助、协助患者满足自护需要。②COPD患者优质护理延伸服务措施短期内对患者生活质量的影响不明显,只有长期追踪、定期评估的管理能够从一定程度上帮助出院患者处理COPD症状带来的影响,提高COPD患者的活动耐力和整体健康状况,改善生活质量。③优质护理延伸服务可以使患者6个月内的复发率显著降低,但对患者疾病加重的次数影响不大,长期的影响还有待进一步研究。④优质护理延伸服务在COPD患者中的开展实现了对我院现有的优质护理服务模式的改进,促进了临床护理服务领域的拓展,为今后相关方面的研宄提供一定的参考和借鉴。
[Abstract]:Objective to investigate and analyze the disease cognition and extended service demand of COPD patients in Department of Respiratory Medicine of the sixth people's Hospital of Kunshan City. Combined with Orrem's self-care theory and health promotion model, the authors explored and formulated the continuous nursing measures and home nursing intervention methods for COPD patients in their own jurisdiction after their stable condition after hospitalization and discharge from hospital. To improve the ability of health self-care of COPD patients in stable period, to improve the quality of life, to reduce the recurrence of disease and to reduce the rate of rehospitalization this study is divided into two parts. The first part is to design a questionnaire on the basis of consulting the literature and asking for the guidance of experts, to select the patients with COPD after discharge from hospital and to investigate the disease cognition and community extension service demand, and to analyze and summarize the corresponding measures of quality nursing extension service. The second part combined with the concept of quality nursing extension service, with the guidance of Orrem self-care theory, according to the characteristics of patients discharged from COPD in their own area, according to the nursing procedures to formulate appropriate home nursing intervention, and organize the implementation and evaluation of the effect. Results the results of investigation on disease cognition and extended service demand of patients with 1COPD were as follows: the elderly were the majority of COPD patients in their own area, their education level was generally low, and most of them lived in rural areas, their travel and movement were inconvenient, and their memory loss and receptivity were poor. The decline of self-care ability and the busy work of children lead to the low cognition of disease in this kind of population. The treatment measures to understand their illness and the method of mastering the function exercise are 29.2and 17.5respectively. The first three places in the survey of the demand for extended services were as follows: drug use guidance accounted for 94.2%, nutrition and diet accounted for 79.2%, Functional exercise guidance accounted for 72.5.2 quality nursing extended service intervention results: there was no significant difference in 6MWT test results between the two groups at discharge and 3 months after discharge (P0.05). But there was significant difference in the results of 6 months (P0.05). There was no significant difference in the degree of dyspnea between the two groups at discharge and 3 months after discharge (P0.05), and the score of dyspnea at 6 months after discharge was significantly lower than that in the control group (P < 0. 05). There was no significant difference in (CAT) between the two groups at discharge and 3 months after discharge (P0.05), but there was significant difference in the results of 6-month CAT survey (P0.05). Two groups of COPD patients in 6 months after discharge from the times of aggravation and recurrence rate differences were statistically significant (P0.05). Conclusion the key of 1COPD patients' quality nursing extension service is to popularize disease related knowledge in a simple and understandable way, to keep regular follow up, to design and plan nursing activities in combination with needs assessment, so as to help. To assist patients to meet the needs of self-care. 2COPD patients quality care extension service measures in the short term, the impact on the quality of life of patients is not obvious, only long-term follow-up, The management of periodic evaluation can help discharged patients deal with the effects of COPD symptoms to some extent, and improve the activity endurance and overall health status of COPD patients. To improve the quality of life. 3 the quality of nursing extension service can significantly reduce the recurrence rate of patients within 6 months, but it has little effect on the number of exacerbations of patients' diseases. The long-term effect needs to be further studied. (4) the extension of quality nursing service in COPD patients has improved the existing mode of quality nursing service in our hospital and promoted the expansion of the field of clinical nursing service. To provide some reference and reference for the related research in the future.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R473.2
本文编号：2362935
[Abstract]:Objective to investigate and analyze the disease cognition and extended service demand of COPD patients in Department of Respiratory Medicine of the sixth people's Hospital of Kunshan City. Combined with Orrem's self-care theory and health promotion model, the authors explored and formulated the continuous nursing measures and home nursing intervention methods for COPD patients in their own jurisdiction after their stable condition after hospitalization and discharge from hospital. To improve the ability of health self-care of COPD patients in stable period, to improve the quality of life, to reduce the recurrence of disease and to reduce the rate of rehospitalization this study is divided into two parts. The first part is to design a questionnaire on the basis of consulting the literature and asking for the guidance of experts, to select the patients with COPD after discharge from hospital and to investigate the disease cognition and community extension service demand, and to analyze and summarize the corresponding measures of quality nursing extension service. The second part combined with the concept of quality nursing extension service, with the guidance of Orrem self-care theory, according to the characteristics of patients discharged from COPD in their own area, according to the nursing procedures to formulate appropriate home nursing intervention, and organize the implementation and evaluation of the effect. Results the results of investigation on disease cognition and extended service demand of patients with 1COPD were as follows: the elderly were the majority of COPD patients in their own area, their education level was generally low, and most of them lived in rural areas, their travel and movement were inconvenient, and their memory loss and receptivity were poor. The decline of self-care ability and the busy work of children lead to the low cognition of disease in this kind of population. The treatment measures to understand their illness and the method of mastering the function exercise are 29.2and 17.5respectively. The first three places in the survey of the demand for extended services were as follows: drug use guidance accounted for 94.2%, nutrition and diet accounted for 79.2%, Functional exercise guidance accounted for 72.5.2 quality nursing extended service intervention results: there was no significant difference in 6MWT test results between the two groups at discharge and 3 months after discharge (P0.05). But there was significant difference in the results of 6 months (P0.05). There was no significant difference in the degree of dyspnea between the two groups at discharge and 3 months after discharge (P0.05), and the score of dyspnea at 6 months after discharge was significantly lower than that in the control group (P < 0. 05). There was no significant difference in (CAT) between the two groups at discharge and 3 months after discharge (P0.05), but there was significant difference in the results of 6-month CAT survey (P0.05). Two groups of COPD patients in 6 months after discharge from the times of aggravation and recurrence rate differences were statistically significant (P0.05). Conclusion the key of 1COPD patients' quality nursing extension service is to popularize disease related knowledge in a simple and understandable way, to keep regular follow up, to design and plan nursing activities in combination with needs assessment, so as to help. To assist patients to meet the needs of self-care. 2COPD patients quality care extension service measures in the short term, the impact on the quality of life of patients is not obvious, only long-term follow-up, The management of periodic evaluation can help discharged patients deal with the effects of COPD symptoms to some extent, and improve the activity endurance and overall health status of COPD patients. To improve the quality of life. 3 the quality of nursing extension service can significantly reduce the recurrence rate of patients within 6 months, but it has little effect on the number of exacerbations of patients' diseases. The long-term effect needs to be further studied. (4) the extension of quality nursing service in COPD patients has improved the existing mode of quality nursing service in our hospital and promoted the expansion of the field of clinical nursing service. To provide some reference and reference for the related research in the future.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R473.2
【参考文献】
相关期刊论文 前10条
1 席明霞;覃琴;唐朝;;延续干预对COPD出院患者自护行为及生活质量的影响[J];护理学杂志;2014年19期
2 丁梅;苏全志;杨丕荣;;延续护理干预对COPD患者生存质量的作用[J];齐鲁护理杂志;2014年17期
3 张俊红;周庆伟;崔青荣;;补肺健脾方及其衍化方剂辨治对COPD患者肺功能影响的临床研究[J];中国中医基础医学杂志;2014年01期
4 陈斌;喻明成;何梅;高启东;何力;万丽;王海燕;陈湘;马瑛;蒋超;王玉莲;何海燕;;关于建立与完善以综合医院为依托的社区护理服务模式的探讨[J];中国医学创新;2013年32期
5 吴茜;毛雅芬;施雁;;对构建医院-社区-家庭慢性病延续性护理模式的思考[J];中国护理管理;2013年08期
6 张玲玲;董邢萍;吴素华;贺树凤;;老年慢性心力衰竭患者出院后医院与社区协同健康管理研究[J];中华健康管理学杂志;2012年05期
7 施雁;王西英;孙晓;;糖尿病病人三元联动健康照护模式在延续护理中的应用[J];中国护理管理;2012年09期
8 李佳梅;成守珍;张朝晖;蔡卫;刘琼慧;谢碧珍;汪牡丹;;延续护理对慢性阻塞性肺疾病患者生存质量的影响[J];中华护理杂志;2012年07期
9 ;改模式 重临床 建机制 优质护理服务将向门急诊延伸[J];中国卫生质量管理;2012年03期
10 李秀云;徐蓉;刘于;肖春梅;;医院—社区—家庭一体化护理照顾模式的构建与实施[J];中国护理管理;2012年05期
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