基于问题导向的慢性病干预行为对老年COPD患者用药依从性及生活质量影响  

Effects of problem-oriented chronic disease intervention behavior on medication compliance and quality of life in elderly COPD patients

作　　者：张利芳 姚星烂 胡晓波 ZHANG Lifang;YAO Xinglan;HU Xiaobo(Department of Pharmacy,Suzhou Ninth People′s Hospital,Jiangsu Province,Suzhou215200,China)

机构地区：[1]江苏省苏州市第九人民医院药剂科,江苏苏州215200

出　　处：《中国医药导报》2020年第31期122-125,共4页China Medical Herald

基　　金：江苏省自然科学基金项目(BK20161384)。

摘　　要：目的探讨临床药师基于问题导向的慢性病干预行为在老年慢性阻塞性肺疾病(COPD)患者中的应用价值。方法选取2019年1—4月江苏省苏州市第九人民医院接收的COPD患者212例,按随机数表法将其分为对照组(106例)和研究组(106例)。对照组给予常规干预,研究组给予基于问题导向的慢性病干预,比较干预后两组患者的自我管理量表、健康状况问卷量表、焦虑自评量表(SAS)和抑郁自评量表(SDS)评分及用药依从情况。结果研究组日常生活管理、自我效能管理、情绪管理、症状管理及信息管理评分高于对照组(均P<0.01);研究组积极乐观、有呼吸机、有家庭氧疗、熟悉疾病知识、知晓用药安全、生活规律饮食健康、已戒烟或正在戒烟等改善评分高于对照组(均P<0.01)。研究组的活力、社会功能、生理功能、情感职能、生理职能、躯体疼痛、心理健康及总体健康评分均高于对照组(均P<0.01)。干预前,两组SAS和SDS评分比较,差异无统计学意义(P>0.05);干预后两组SAS和SDS评分均低于干预前,且研究组低于对照组(均P<0.01)。研究组总依从率高于对照组(P<0.05)。结论临床药师基于问题导向的慢性病干预行为在老年COPD患者中的应用价值较高,能提高患者自我管理能力及用药依从性,缓解负性情绪,提高日常生活质量。Objective To investigate the application value of problem-oriented chronic disease intervention behavior of clinical pharmacists in elderly patients with chronic obstructive pulmonary disease(COPD).Methods A total of 212 COPD patients admitted to Suzhou Ninth People′s Hospital of Jiangsu Province from January to April 2019 were selected.They were divided into the control group(106 cases)and the study group(106 cases)according to the random number table method.The control group was given routine intervention,while the study group was given problem-oriented chronic disease intervention.After the intervention,the self-management scale,health status questionnaire,anxiety self-rating scale(SAS)and depression self-rating scale(SDS)and medication compliance of the two groups were compared.Results The scores of daily life management,self-efficacy management,emotion management,symptom management and information management in the study group were higher than those in the control group(all P<0.01).The improved scores of positive and optimistic,with ventilator,with home oxygen therapy,familiar with disease knowledge,drug safety,healthy diet and lifestyle,and have quit smoking or are quitting smoking in the study group were higher than those in the control group(all P<0.01).The vitality,social function,physiological function,emotional function,physical function,physical pain,mental health and overall health scores of the study group were all higher than those of the control group(all P<0.01).Before intervention,there were no significant differences in SAS and SDS scores of the two groups(P>0.05);after intervention,SAS and SDS scores of the two groups were lower than those before intervention,and the study group were lower than the control group(all P<0.01).The total compliance rate of study group was higher than that of control group(P<0.05).Conclusion Clinical pharmacist problem-oriented chronic disease intervention behavior has higher application value in elderly patients with COPD,which can improve patients′self-manage

关 键 词：老年慢性阻塞性肺疾病 慢性病干预 基于问题导向 应用价值 

分 类 号：R563.9[医药卫生—呼吸系统]