基于问题导向的慢性病护理干预行为对提高老年慢性阻塞性肺疾病(COPD)患者自我管理能力、负性情绪及生活质量的效果  

Effects of Problem-oriented Chronic Disease Nursing Intervention on Improving the Self-management Ability,Negative Emotions and Quality of Life of Elderly Patients with COPD

作　　者：廖茂[1] 程潇艺 王燕[1] LIAO Mao;CHENG Xiaoyi;WANG Yan(Department of Geriatrics,Leshan Hospital of Traditional Chinese Medicine,Sichuan Leshan 614000,China)

机构地区：[1]四川省乐山市中医医院老年病科

出　　处：《中国健康心理学杂志》2018年第11期1697-1702,共6页China Journal of Health Psychology

摘　　要：目的：探讨基于问题导向的慢性病护理干预行为对老年COPD患者自我管理能力、负性情绪及生活质量的影响。方法：收集2014年4月-2016年4月我院呼吸内科收治的COPD患者120例,按照先后入院的顺序,2014年4月-2015年4月收治的60例为对照组,给予常规护理干预;2015年4月-2016年4月收治的60例为观察组,给予以问题为导向的慢性病护理干预,干预6个月后采用自我管理能力评分表、汉密尔顿抑郁量表（HAMD）、汉密尔顿焦虑量表（HAMA）和健康状况问卷量表（SF-36）对两组患者进行评分。结果：观察组干预后相关问题如熟悉疾病知识、知晓用药安全、有家庭氧疗、有呼吸机、已戒烟或正在戒烟、积极乐观、生活规律饮食健康均较干预前好转（t=5.021,8.780,6.011,7.429,10.812,4.009,7.714;P〈0.05）;观察组干预后上述问题改善情况明显优于对照组（t=5.090,7.106,7.797,7.566,9.151,5.619,8.128;P〈0.05）;观察组出院6个月后症状管理（t=8.761,P=0.000）、情绪管理（t=8.140,P〈0.05）、信息管理（t=7.030,P〈0.05）、日常生活管理（t=4.641,P〈0.05）、自我效能管理评分（t=5.696,P〈0.05）均明显高于对照组;与对照组比较,观察组干预后HAMD评分和HAMA评分明显降低（t=4.491,7.788;P〈0.05）。结论：基于问题导向的慢性病护理干预行为能提高老年COPD患者的自我管理能力,进而改善患者的生活质量。Objective： To explore the effects of problem-oriented chronic disease nursing intervention on improving the self-management ability,negative emotions and quality of life of elderly patients with COPD.Methods： A total of 120 cases of COPD patients treated in department of respiratory medicine of our hospital were collected from April 2014 to April 2016.According to the order of admission,60 cases of patients treated from April 2014 to April 2015 were selected as the control group and were given routine nursing intervention,and another 60 cases of patients treated from April 2015 to April 2016 were enrolled in the observation group and were given problem-oriented chronic disease nursing intervention. At 6 months after intervention,the patients in the two groups were scored by the self-management ability scale,the Hamilton Depression Scale（ HAMD）,the Hamilton Anxiety Scale（ HAMA） and the Health Status Questionnaire（ SF-36）.Results： After intervention,the related problems in the observation group such as familiarity with the disease knowledge,drug safety awareness,family oxygen therapy,ventilator,having quit smoking or quit smoking,being positive and optimistic,regular life and healthy diet were better than those before intervention（ t = 5.021,8.780,6.011,7.429,10.812,4.009,7.714; P〈0.05）. The improvement of the above problems were significantly better in the observation than that in the control group（ t = 5. 090,7. 106,7.797,7.566,9.151,5. 619,8. 128; P〈0. 05）. The symptom management（ t = 8. 761,P〈0. 05）,emotional management（ t = 8.140,P〈0.05）,information management（ t = 7.030,P〈0.05）,daily life management（ t = 4.641,P〈0.05）,self-efficacy management score（ t = 5.696,P〈0.05） after 6 months of discharge were significantly higher in the observation group than that in the control group.Compared with the control group,the HAMD score and the HAMA score were significantly lower in the observation group（ t = 4.491,7.788; P〈0.05）.Conclusion： Problem-oriented

关 键 词：慢性病护理 慢性阻塞性肺疾病 自我管理 生活质量 

分 类 号：R749.92[医药卫生—神经病学与精神病学]