从慢性病自我管理、自我效能的角度对慢性阻塞性肺疾病综合性肺康复的评价  

Evaluation of self-management, self-efficacy in the comprehensive pulmonary rehabilitation for COPD

作　　者：蒋胜华[1] 李岷[1] 秦茂华[1] 曹秀芬[1] 张秀莲[1] 山凤莲[1] 宋敏[1] 姜鲁宁[1] 

机构地区：[1]山东省济宁医学院附属医院呼吸内科,济宁272100

出　　处：《中国康复医学杂志》2017年第9期1030-1034,共5页Chinese Journal of Rehabilitation Medicine

基　　金：济宁市科技局基金项目(2012jnnk02;2013jnw54);济宁医学院青年基金项目(JYQ2011KM061)

摘　　要：目的:本研究从慢性病自我管理、自我效能的角度,评价对中重度稳定期慢性阻塞性肺疾病(COPD)进行综合性肺康复的价值。方法:选择呼吸科进行肺康复训练的Ⅱ—Ⅳ级慢阻肺患者26例为研究对象,实施院内综合康复训练和院外康复跟踪指导,分别测量患者入院康复训练时、康复训练半年时的运动耐力(BODE指数),分别填写"自我管理量表、自我效能量表",观察康复训练干预效果。结果:肺康复前的自我管理总分:122.61±11.92,自我效能总分:31.50±4.76;BODE指数分别为:体重指数(BMI):22.88±3.22,第1秒用力肺活量占预计值百分比(FEV1%Pred):47.97±6.42,改良的英国医学研究委员会呼吸困难量表(MMRC):2.26±0.59,6分钟步行距离(6MWD):343.38±54.45。训练半年后资料分析显示:患者自我管理总分:182.82±8.49,自我效能总分:46.64±4.47,均高于肺康复前得分,差异具有显著性意义(P<0.05)。BODE指数分别为:BMI:23.03±3.07,FEV1%Pred:48.54±6.40,MMRC:1.70±0.55,6MWD:385.31±57.22,较前比较呼吸困难评分下降,6MWD增加,差异具有显著性意义(P<0.05)。结论:综合性肺康复可以提高患者的自我管理水平、自我效能感,有效减轻COPD患者的呼吸困难症状、增强活动耐力、延缓病情进展。Objective： To evaluate the effects of comprehensive pulmonary rehabilitation therapy on self-management, selfefficacy of patients with moderate and severe COPD.Method： Twenty-six moderate and severe COPD patients accepted treatment in our hospital were enrolled in this study. Treatment strategies included routine drug therapy and comprehensive pulmonary rehabilitation for 6months. Self-management, self-efficacy questionnaire survey and BODE index were adopted before and after treatment to evaluate the efficacy of comprehensive pulmonary rehabilitation therapy.Result： After comprehensive pulmonary rehabilitation for 6 months, the self-management（182.82±8.49）, self-efficacy（46.64 ± 4.47） and 6MWD scores（385.31 ± 57.22） improved than before（corresponding 122.61 ± 11.92,31.50 ±4.76,343.38±54.45）significantly. The total score of BODE index（BMI：23.03±3.07,FEV1%Pred：48.54±6.40） and MMRC（1.70±0.55） score were getting lower than before（22.88±3.22,47.97±6.42）.Conclusion： Comprehensive pulmonary rehabilitation can improve the level of self-management, self-efficacy and exercise tolerance of patients with COPD.

关 键 词：慢性阻塞性肺疾病 肺康复 自我管理水平 自我效能 

分 类 号：R563.9[医药卫生—呼吸系统]