行动导向教育法对稳定期COPD患者肺康复效果研究

发布时间：2018-01-10 08:07

本文关键词：行动导向教育法对稳定期COPD患者肺康复效果研究　出处：《青岛大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的探讨行动导向教育法对COPD患者肺功能康复的影响,进而提高患者行为的依从性,达到缓解患者呼吸困难症状和改善生活质量的目的,为COPD患者肺康复的健康教育提供临床实践经验和科学依据。方法研究对象选取2016年3月至2017年1月青岛市某三甲医院90例COPD稳定期患者分为干预组和对照组。对照组患者给予常规治疗和护理,干预组通过文献回顾、专家咨询、临床访谈等方法基础上确定行动导向教育法干预方案,干预组在常规治疗的基础上给予行动导向教育法的干预方案,出院后电话随访和健康指导。两组分别在住院期间、出院后1个月、3个月和6个月进行资料收集,包括肺功能指标、6分钟步行距离和圣·乔治医院呼吸问题调查问卷(The St George’S Respiratory Questionnaire SGRQ)生活质量的测评。全部数据采用SPSSl7.0软件处理。结果1.干预前两组患者的一般资料情况,基本临床资料比较差异无统计学意义(P0.05),两组数据具有可比性,两组患者各项评价指标(肺功能、生活质量、6分钟步行试验、呼吸困难评分等)基线比较,差异均无统计学意义(P0.05),两组具有可比性。2.干预前两组患者的肺功能对比无明显统计学差异(P0.05)。干预后1个月FEVl、FVC、FEV1/FVC干预组相比于对照组两组间对比差异具无统计学意义,t值分别为0.198、0.463和0.046(P0.05);干预3个月FEVl、FVC、FEV1/FVC干预组相比于对照组两组比较相比差异有统计学意义,t值分别为3.53、2.89和2.20(P0.05);干预6个月FEVl、FVC、FEV1/FVC干预组相比于对照组两组比较相比差异有统计学意义,t值分别为5.48、4.06和5.00(P0.05)。3.干预前两组患者的SGRQ各项得分对比无明显统计学差异(P0.05)。干预后,干预组患者SGRQ总分(36.50±3.07)低于对照(49.37±3.71);干预组患者症状得分(35.45±5.45)低于对照(52.32±4.61);干预组患者活动能力得分(43.89±10.60)低于对照(61.67±5.45);干预组患者疾病对生活的影响得分(32.93±5.40)低于对照(44.74±6.12),差异具有统计学意义(P0.05)。4.干预组和对照组6分钟步行试验比较,干预1个月(263.25±28.25)、3个月(269.20±28.50)、6个月(274.15±27.43)相对于对照组1个月(241.76±263.25)、3个月(241.43±18.91)、6个月(232.05±38.34)有所提高,差异具有统计学意义(P0.05)。结论行动导向教育法有助于改善COPD患者的肺功能,缓解患者的呼吸困难程度,提高患者的生活质量。研究中将行动导向教育法作为健康教育的一部分和住院护理的延伸,使患者回到家中通过行为的转变从而达到肺康复的目的,护士对患者进行反复、有针对性的行为指导,提高患者对疾病的认知,改善患者的日常不良行为,通过随访和复诊加强患者出院后遵医行为,可以起到延缓患者肺功能的持续下降,改善患者的生存质量的目的。
[Abstract]:Objective to explore the effect of action oriented education on the rehabilitation of pulmonary function in patients with COPD, so as to improve the compliance of patients with behavior, so as to alleviate the symptoms of dyspnea and improve the quality of life. To provide clinical experience and scientific basis for health education of lung rehabilitation in patients with COPD. Methods 90 cases of stable COPD in a third Class A Hospital in Qingdao from March 2016 to January 2017 were selected. The patients were divided into the intervention group and the control group. The patients in the control group were given routine treatment and nursing. Intervention group through literature review, expert consultation, clinical interviews and other methods based on the determination of action oriented education intervention program, intervention group on the basis of routine treatment on the basis of action oriented education intervention program. After discharge, data were collected during hospitalization, 1 month, 3 months and 6 months after discharge, including pulmonary function indicators. 6-minute walk distance and St. George's Hospital Respiratory questionnaire, the St George'S Respiratory Questionnaire SGRQ. Quality of life evaluation. All data were processed by SPSSl7.0 software. Results 1. General data of the two groups before intervention. 2. There was no significant difference in the basic clinical data between the two groups (P 0.05). The two groups had comparable data. The two groups had different evaluation indexes (lung function, quality of life, 6-minute walking test). Compared with baseline, there was no significant difference (P 0.05). Before intervention, there was no significant difference in pulmonary function between the two groups (P 0.05). One month after intervention, FEVlFVC. There was no significant difference between FEV1/FVC intervention group and control group (0.198 0.63 vs 0.046 P 0.05). After 3 months of intervention, the FEVlC1 / FVC intervention group was significantly higher than that of the control group (3.53, P < 0.05). 2.89 and 2.20 P0.05; After 6 months of intervention, there was significant difference in FEVlC1 / FEV1 / FVC intervention group compared with the control group (5.48). Before intervention, there was no significant difference in the scores of SGRQ between the two groups. The total score of SGRQ in the intervention group (36.50 卤3.07) was lower than that in the control group (49.37 卤3.71). The symptom score of intervention group (35.45 卤5.45) was lower than that of control group (52.32 卤4.61). The score of activity ability in the intervention group (43.89 卤10.60) was lower than that in the control group (61.67 卤5.45). The score of the effect of disease on life in the intervention group was 32.93 卤5.40, which was lower than that in the control group (44.74 卤6.12). The difference was statistically significant (P 0.05). The 6-minute walking test between the intervention group and the control group was 263.25 卤28.25 in 1 month. Compared with the control group, it was 269.20 卤28.50 and 274.15 卤27.43 at 3 months, and 241.76 卤263.25 at 1 month respectively. In 3 months, 241.43 卤18.91 and 232.05 卤38.34 respectively. Conclusion Activity-oriented education method can improve the pulmonary function of patients with COPD and alleviate the degree of dyspnea in patients with COPD. To improve the quality of life of patients. In the study, as a part of health education and the extension of in-patient care, the action oriented education method is used to make patients return home through behavior change to achieve the purpose of lung rehabilitation. Nurses repeatedly, targeted behavior guidance, improve the patient's understanding of the disease, improve the patients' daily bad behavior, through follow-up and follow-up to strengthen the patient's compliance behavior after discharge. It can delay the continuous decline of pulmonary function and improve the patient's quality of life.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.5

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