过渡期护理计划模式在COPD患者中的临床应用效果研究

目的对COPD患者实施过渡期护理计划模式(TCM),探讨其对患者过渡时间、功能状态、自我护理行为的影响。方法采用便利抽样法,选择郑州大学附属郑州中心医院2015年3月—2018年3月的168例COPD患者为研究对象,根据入院时间分为观察组(n=96)和对照组(n=72)。对照组行常规护理管理,观察组实施TCM管理。记录两组患者过渡时间,比较两组患者干预前后6 min步行距离(6MWD)和肺功能指标,采用患者自我护理行为问卷比较两组患者自我护理行为得分。结果观察组患者过渡时间为(5.02±1.79)个月,对照组为(3.75±1.33)个月,差异有统计学意义(t=3.578,P<0.01)。干预后,观察组患者6MWD(278.15±51.26)m,第1秒用力肺活量占用力肺活量的比值(FEV1/FVC%)(67.48±10.21)%,均较对照组提高,差异有统计学意义(t值分别为3.068、3.224;P<0.05)。干预后观察组一般性自理需求评分(46.12±4.54)分,健康偏离性自理需求评分(50.74±4.81)分,均高于对照组,差异有统计学意义(t值分别为11.991、9.626;P<0.01)。结论TCM管理用于院外COPD患者过渡期护理,有助于提高患者肺功能和运动耐力,改善患者自我护理行为。

Clinical effects of transitional care model in COPD patients

Objective To explore the effects of transitional care model(TCM)for chronic obstructive pulmonary disease(COPD)patients on the transition time,functional status and self-care behavior.Methods From March 2015 to March 2018,we selected 168 COPD patients at Zhengzhou Central Hospital Affiliated to Zhengzhou University as subjects by convenience sampling.All of patients were divided into observation group(n=96)and control group(n=72)according to admission time.Control group carried out routine nursing management,while observation group implemented TCM management.This study recorded the transition time,and compared the 6-Minute Walk Distance(6MWD)as well as lung function indexes of patients between two groups before and after intervention.The scores of self-care behavior of patients between two groups were also compared with the Self-care Behavior Questionnaire.Results The transition time of patients in observation group and control group was(5.02±1.79)months and(3.75±1.33)months respectively with a statistical difference(t=3.578,P<0.01).After intervention,the 6MWD and forced expiratory volume in one second percentage occupied by forced vital capacity(FEV1/FVC%)of patients in observation group was(278.15±51.26)m and(67.48±10.21)%respectively,higher than those in control group with statistical differences(t=3.068,3.224;P<0.05);the scores of general self-care need and health deviation self-care need of observation group were(46.12±4.54)and(50.74±4.81)respective higher,than those of control group with statistical differences(t=11.991,9.626;P<0.01).Conclusions Application of TCM management in transitional care for COPD patients helps to improve patients'lung function,exercise tolerance and self-care behavior.