认知图式健康教育联合家属陪同叙事疗法在老年COPD患者中的应用  

Application of cognitive schema health education combined with family-accompanied narrative therapy in elderly patients with COPD

作　　者：周亚捷 汪桂琴 罗晓华[1] 石伟伟 许慧慧[1] 韩晓霞[1] Zhou Yajie;Wang Guiqin;Luo Xiaohua;Shi Weiwei;Xu Huihui;Han Xiaoxia(Department of Nursing,The Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第五附属医院护理部,郑州450000

出　　处：《保健医学研究与实践》2022年第4期121-125,共5页Health Medicine Research and Practice

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20190411);河南省医学教育研究课题(Wjlx2017040)。

摘　　要：目的探讨认知图式健康教育联合家属陪同叙事疗法对老年慢性阻塞性肺疾病(COPD)患者疾病感知及症状负担的影响。方法选取2018年1月—2020年12月郑州市某医院收治的88例老年COPD患者,采用随机数字表法分为观察组与对照组,每组44例。对照组患者采用家属陪同叙事疗法进行护理,观察组患者在对照组基础上联用认知图式健康教育进行护理,均持续干预2周。比较2组患者干预前后记忆症状评估量表(MSAS)、简易疾病感知问卷(BIPQ)、医学应对方式问卷(MCMQ)评分,肺功能及干预期间的肺部感染发生情况。结果2组患者干预后MSAS各维度评分均低于干预前,且观察组低于对照组,差异均有统计学意义(P<0.05)。2组患者干预后BIPQ评分均高于干预前,且观察组高于对照组,差异均有统计学意义(P<0.05)。2组患者干预后MCMQ中面对维度评分高于干预前且观察组高于对照组,回避及屈服维度评分低于干预前且观察组低于对照组,差异均有统计学意义(P<0.05)。2组患者干预后第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC水平均高于干预前,且观察组高于对照组,差异均有统计学意义(P<0.05)。观察组患者肺部感染率为9.09%,低于对照组的25.00%,差异有统计学意义(χ^(2)=3.938,P=0.047)。结论认知图式健康教育联合家属陪同叙事疗法有助于提高老年COPD患者的疾病感知能力,改善疾病应对方式及肺功能,减轻其症状负担水平。Objective To explore the effects of cognitive schema health education combined with family-accompa-nied narrative therapy on the disease perception and symptom burden of elderly patients with chronic obstructive pulmonary disease(COPD).Methods Eighty-eight cases of elderly COPD patients admitted to a hospital in Zhengzhou from January 2018 to December 2020 were selected and divided into an observation group and a control group using a random number table,with 44 cases in each group.Patients in the control group were cared for with family-accompanied narrative therapy,and patients in the observation group were cared for with cognitive schema health education in addition;the intervention continued in both groups for 2 weeks.Patients in the two groups were compared before and after the intervention for memory symptom assessment scale(MSAS),brief illness perception questionnaire(BIPQ),medical coping modes questionnaire(MCMQ)scores,lung function and the occurrence of lung infections during the intervention.Results After the intervention,the scores of MSAS in both groups were lower than those before the intervention,and those in the observation group were lower than those in the control group,with statistically significant differences(P<0.05).The levels of the forced expirato-ry volume in 1 second(FEV1),forced vital capacity(FVC)and FEV1/FVC were higher in both groups than be-fore the intervention and higher in the observation group than in the control group,with statistically significant differences(P<0.05).The lung infection rate of patients in the observation group was 9.09%,which was lower than that of 25.00%in the control group,and the difference was statistically significant(χ^(2)=3.938,P=0.047). Conclusion Cognitive schema health education combined with family-accompanied narrative therapy helps to improve disease perception, enhance disease coping and pulmonary function, and reduce the level of symptom burden in elderly COPD patients.

关 键 词：认知图 家属陪同叙事疗法 慢性阻塞性肺疾病 疾病感知能力 症状负担 

分 类 号：R473.5[医药卫生—护理学]