院外服务计划在慢性阻塞性肺疾病患者中的应用

目的：评价慢性阻塞性肺疾病（ COPD ）患者应用院外服务计划的实践成效。方法将86例COPD患者按照住院号的奇偶数随机分为对照组和干预组各43例，干预组实施院外服务计划，对照组按常规护理和随访。两组患者出院后30，60，180 d后进行西雅图阻塞性肺疾病问卷（ SOLDQ）的测量。结果经6个月干预，干预组患者的疾病复发次数、再入院次数及体质量指数分别为（1．08±0．53），（0．68±0．30），（22．64±3．60），优于对照组的（2．57±1．12），（1．70±0．80），（17．55±2．74），差异有统计学意义（t值分别为-2．957，-3．549，3．078；P＜0．05）。两组患者的自我管理认知水平入院时差异无统计学意义（P＞0．05），出院前干预组患者的自我管理认知水平评分为（15．23±3．59）分，高于对照组的（13．27±3．22）分，差异有统计学意义（t＝2．806，P＜0．05）；出院前，两组患者的SOLDQ评分差异无统计学意义（P＞0．05），干预后6个月，干预组患者的生理功能、情绪功能、护理满意度得分均高于对照组，差异有统计学意义（ t值分别为14．300，10．673，11．231；P＜0．05）。结论院外服务计划的实施可以提升COPD患者自我管理认知能力，减少疾病复发次数及再入院次数，提高生活质量。

Application of discharge planning services in patients with chronic obstructive pulmonary disease

Objective To evaluate the effect of discharge planning services in patients with chronic obstructive pulmonary disease （ COPD ） .Methods Eighty six COPD patients were divided into two groups . There were 43 cases in each group .The patients in the experimental group received discharge planning services , while the control group received routine follow-up services.The quality of life was measured by the Seattle Obstructive Lung Disease Questionnaire （SOLDQ） and was compared between groups on the 30th, 60th and 180th days after discharge .Results After 6 month intervention , the incidence of disease , hospital readmission and body max index of the experimental group were （1.08 ±0.53）, （0.68 ±0.30） and （22.64 ±3.60）, respectively.Those in the control group were （2.57 ±1.12）, （1.70 ±0.80） and （17.55 ±2.74）.There were significant differences between the two groups （t=-2.957, -3.549, 3.078, respectively;P〈0.05）. There were no significant different in self care knowledge before admission to the hospital between the two groups （P〉0.05）.Before discharge, the self care knowledge in the experimental group were （15.23 ±3.59）, which were significantly higher than （13.27 ±3.22） in the control group （t =2.806,P〈0.05）.There were no significant different in the SOLDQ score before admission to the hospital between the two groups （P〉0.05）. After 6 month intervention , the score of physical function , emotional function and satisfaction with self care in the experimental group were significantly higher than those in the control group （t=14.300, 10.673, 11.231, respectively;P〈0.05）.Conclusions Discharge planning services can enhance the ability of self-care and reduce the frequency of acute exacerbation .