结构-过程-结果三维质量评价模式应用在COPD患者延续护理中的效果  

Application effects of structure-process-outcome three dimensional quality assessment model on transitional care in patients with COPD

作　　者：王丹[1] 吴柳[1] 张小冯[1] 冯丽芳[1] 许晓燕[1] 

机构地区：[1]解放军总医院南楼呼吸科一病区,北京100853

出　　处：《中华现代护理杂志》2016年第2期156-159,共4页Chinese Journal of Modern Nursing

摘　　要：目的 探索结构过程结果三维质量评价模式在COPD患者延续护理中的应用,以提高出院患者的身体状况和生活质量.方法 以Donabedian的结构过程结果三维质量评价模式为理论框架,构建COPD出院患者的延续护理方案;通过对延续护理服务项目的结构评估、过程评估及结果评价,使延续性护理工作得到了有效落实,同时运用圣乔治呼吸问卷（SGRQ）和6 min步行试验（6MWT）分别评价对患者生活质量和身体状况的改善效果.结果 干预前患者平均6 min步行距离为（263.15±15.35）m,干预后提高到（343.24±22.14）m,干预前后差异有统计学意义（P〈0.01）.实施延续护理后,患者的SGRQ调查中症状、活动受限、疾病影响各维度及总分较干预前均下降、6MWT较干预前提高,差异均有统计学意义（t值分别为16.357,12.458,14.399,16.669;P〈0.01）.结论 Donabedian的结构过程结果三维质量评价模式是提升COPD患者延续性护理质量的有效手段,能提高患者的生活质量和身体状况.Objective To evaluate the application effects of structure-process-outcome three dimensional quality assessment model on transitional care in patients with chronic obstructive pulmonary disease （ COPD） . Methods On the basis of Donabedian′s structure-process-outcome quality of care model, a transitional care program was designed and carried out for the discharged patients with COPD. The transitional nursing intervention had been effectively implemented through the structural evaluation, process evaluation and outcomes evaluation. At the same time, Saint Gorge-s Respiratory Questionnaire（ SGRQ） and 6 minutes-walking test were used to assess the improvement effects. Results The average walking distance in 6 minutes was （ 263. 15 ±15.35）m before the intervention and was （343. 24 ± 22. 14） m after intervention （P 〈0. 01）. After the implementation of intervention, the scores of symptoms in the SGRQ survey, limitation of movement and influence of disease decreased, but the score of 6MWT increased （t =16. 357, 12. 458, 14. 399, 16. 669;P 〈0. 01）. Conclusions Donabedian′s structure-process-outcome three dimensional quality assessment model is an effective approach to improve the quality of transitional care for patients with COPD, and significantly improve patients′quality of life and physical condition.

关 键 词：肺疾病 慢性阻塞性 生活质量 出院后医疗 结构过程结果三维质量评价模式 

分 类 号：R473.5[医药卫生—护理学]