慢性阻塞性肺疾病患者长程家庭氧疗信念和行为的干预效果研究

发布时间：2019-01-02 12:08

【摘要】：背景:慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease,COPD)患者常存在低氧血症,不仅影响患者的生理功能,而且对心理健康和生活质量造成严重影响。长程家庭氧疗可以纠正低氧血症、改善预后、提高生活质量,然而目前COPD患者长程家庭氧疗的现状堪忧,针对长程家庭氧疗的干预多是给予知识,忽视了信念对行为改变的重要性。HBM(Health Belief Model,HBM)通过使患者树立健康的信念,进而形成健康的行为,为促进行为的改变提供了理论依据。目的:评价基于HBM的干预措施对提高COPD患者长程家庭氧疗信念和长程家庭氧疗行为的有效性。方法:本研究属于类实验性研究,于2016年8月至2017年4月,便利选取北京北京大学首钢医院和中国医科大学航空总医院呼吸内科病房即将出院的COPD患者78例。首钢医院的研究对象按病区进行分组,航空总医院的研究对象按时间先后进行分组,干预组和对照组各39例。干预组研究对象接受基于HBM的干预措施,并发放长程家庭氧疗知识手册、讲解并演示长程家庭氧疗步骤。对照组研究对象接受常规出院教育,包括发放和讲解知识手册并解答患者疑问。在干预前、干预完成时、干预后1个月、干预后3个月,采用长程家庭氧疗健康信念问卷和长程家庭氧疗执行情况问卷分别对两组研究对象的长程家庭氧疗信念和长程家庭氧疗行为进行测评,患者平均每日吸氧时间采用自我报告形式。结果:本研究共75例研究对象完成资料收集,其中干预组38例,对照组37例。研究结果显示:(1)干预完成时、干预后1个月、干预后3个月,长程家庭氧疗信念总分显著高于同期的对照组(P0.05),且显著高于干预前(P0.008);(2)干预组与对照组比较,干预组研究对象在干预后各时点的长程家庭氧疗行为得分和平均每日吸氧时间均显著高于同期对照组(P0.05),且显著高于干预前(P0.008)。结论:在COPD人群中,实施基于HBM的干预措施对提高患者长程家庭氧疗信念和长程家庭氧疗行为是有效的。HBM从信念形成的角度出发,为提高COPD患者的长程家庭氧疗行为提供了新的途径。
[Abstract]:Background: chronic obstructive pulmonary disease (Chronic Obstructive Pulmonary Disease,COPD) patients often have hypoxemia, which not only affects the physiological function of patients, but also has a serious impact on mental health and quality of life. Long-range family oxygen therapy can correct hypoxemia, improve prognosis and improve the quality of life. However, the current situation of long-term family oxygen therapy in COPD patients is worrying, the intervention for long-term family oxygen therapy is to give knowledge. Ignoring the importance of belief to behavior change (. HBM (Health Belief Model,HBM) provides a theoretical basis for promoting behavior change by enabling patients to establish healthy beliefs and then to form healthy behaviors. Objective: to evaluate the effectiveness of HBM-based intervention in improving long-range family oxygen therapy beliefs and long-range home oxygen therapy behaviors in patients with COPD. Methods: from August 2016 to April 2017, 78 COPD patients were selected from Shougang Hospital of Peking University and General Hospital of Aeronautical General Hospital of China Medical University. The subjects in Shougang Hospital were grouped according to the disease area, and those in Aviation General Hospital were divided into three groups according to time, 39 cases in the intervention group and 39 cases in the control group. The subjects of the intervention group accepted the intervention measures based on HBM, and issued the knowledge manual of long range family oxygen therapy to explain and demonstrate the long range family oxygen therapy steps. Subjects in the control group received routine discharge education, including issuing and explaining knowledge manuals and answering patients' questions. Before the intervention, when the intervention was completed, 1 month after the intervention, 3 months after the intervention, The long range family oxygen therapy beliefs and the long range family oxygen therapy behaviors of the two groups were measured by the long range Family oxygen Therapy Health belief questionnaire and the long range Family oxygen Therapy performance questionnaire, respectively. The average daily oxygen intake time of the patients was self-reported. Results: a total of 75 subjects completed the data collection, including 38 cases in the intervention group and 37 cases in the control group. The results showed that: (1) at the end of the intervention, 1 month after the intervention and 3 months after the intervention, the total score of long-term family oxygen therapy belief was significantly higher than that of the control group (P0.05) and significantly higher than that before the intervention (P0.008); (2) compared with the control group, the scores of long-term family oxygen therapy behavior and the average daily oxygen inhalation time in the intervention group were significantly higher than those in the control group (P0.05) and significantly higher than those before the intervention (P0.008). Conclusion: in COPD population, the intervention based on HBM is effective to improve patients' long-term family oxygen therapy belief and long-term family oxygen therapy behavior. HBM starts from the perspective of belief formation. It provides a new way to improve the long-range home oxygen therapy in COPD patients.
【学位授予单位】：北京协和医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.5

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