目标管理护理干预模式在老年慢性阻塞性肺疾病患者中的应用

目的：探讨目标管理护理干预模式对老年慢性阻塞性肺疾病患者睡眠质量、心理健康状况、肺功能及疾病自我护理能力的影响。方法：选取2020年1月至2021年6月收治的110例老年慢性阻塞性肺疾病患者，分为对照组和干预组各55例。对照组患者应用常规护理模式，干预组患者应用目标管理护理干预模式，两组护理周期均为2个月。采用重复测量方差分析法比较两组护理前、护理1个月、护理2个月后睡眠质量、心理健康状况得分差异性。采用卡方检验，独立样本t检验比较两组护理2个月后肺功能和自我护理能力的得分差异。结果：护理前，两组的匹兹堡睡眠质量指数，汉密尔顿焦虑量表和抑郁量表评分差异均无统计学意义（P>0.05）。护理1个月、2个月后，干预组匹兹堡睡眠质量指数，汉密尔顿焦虑量表和抑郁量表评分均低于对照组，差异有统计学意义（P<0.05）。两组的匹兹堡睡眠质量指数，汉密尔顿焦虑量表和抑郁量表评分均随干预时间的变化而变化，干预方法与干预时间之间存在交互效应（P<0.05）。此外，护理2个月后，干预组肺功能分级<Ⅲ级率及疾病自我护理能力评分高于对照组，差异有统计学意义（P<0.05）。结论：目标管理护理干预模式能够增强老年慢性阻塞性肺疾病患者自我保健意识，提高患者自我护理能力，改善患者睡眠质量、心理健康状况，促进疾病康复。

Application of goal-setting model of nursing intervention in elderly patients with chronic obstructive pulmonary disease

Objective: To explore the effect of goal-setting nursing intervention on sleep quality, mental health, lung function and self-care ability in elderly patients with chronic obstructive pulmonary disease(COPD). Methods: A total of 110 elderly patients with COPD admitted from January 2020 to June 2021 were selected and divided into control group and intervention group, 55 cases in each group. The patients in the control group received routine nursing mode for 2 months, while patients in the intervention group received goal-setting model management. Repeated measures analysis of variance was used to compare the scores of sleep quality and psychological state between the two groups before nursing, at 1 month and 2 months after nursing. Chi square and independent T-test were adopted to compare the score of pulmonary function and self-care ability. Results: Before intervention, there were no significant differences in Pittsburgh sleep quality index(PSQI), Hamilton anxiety scale (HAMA) and Hamilton depression scale(HAMD) between the two groups (P>0.05). The scores of PSQI, HAMA and HAMD in the intervention group were lower than those in the control group at 1 month and 2 months after intervention(P<0.05). All the scores changed with the change of intervention time, and there was interaction effect between intervention method and intervention time(P<0.05). Moreover, the rate of pulmonary function low grade 3 and the score of self-care ability of patients in the intervention group were superior to the patients in the other group at 2 months after intervention(P<0.05). Conclusion: The application of goal-setting nursing intervention in the clinical nursing of elderly patients with COPD can advance patients’ health care consciousness and self-care ability, and improve patients’ sleep quality, psychological health and rehabilitation effect.