行为分阶段转变理论的个案管理模式在慢性阻塞性肺疾病稳定期患者中的应用  

Application of the case management model based on the theory of phased behavior transformation in patients with stable period of chronic obstructive pulmonary disease

作　　者：吴林珂[1] 张琦婉 俞颖[2] 吕利杰 毛山[1] 谷伟[1] 叶亮[1] WU Linke;ZHANG Qiwan;YU Ying;LYU Lijie;MAO Shan;GU Wei;YE Liang(Department of Respiratory and Critical Care Medicine,Nanjing First HospitalAffiliated to Nanjing Medical University,Jiangsu Province,Nanjing 210006,China;Department of Internal Medicine,Nanjing First HospitalAffiliated to Nanjing Medical University,Jiangsu Province,Nanjing 210006,China)

机构地区：[1]南京医科大学附属南京医院南京市第一医院呼吸与危重症医学科,江苏南京210006 [2]南京医科大学附属南京医院南京市第一医院内科,江苏南京210006

出　　处：《中国医药导报》2024年第5期176-180,共5页China Medical Herald

基　　金：江苏省医院协会医院管理创新研究课题(JSYGY-3-2020-299);江苏省南京市卫生科技发展重点项目(ZKX21041)。

摘　　要：目的探讨行为分阶段转变理论的个案管理模式在慢性阻塞性肺疾病(以下简称“慢阻肺”)稳定期患者中的应用效果。方法纳入南京市第一医院2021年6月至2022年6月门诊访视的112例慢阻肺稳定期患者进行前瞻性研究,通过随机数字表法将其分为对照组和观察组,各56例。对照组给予个案管理模式干预,观察组给予行为分阶段转变理论的个案管理模式。两组均连续干预6个月。比较干预前、干预6个月后呼吸功能[圣乔治呼吸问卷(SGRQ)、改良版英国医院研究委员会呼吸困难量表(m MRC)]、自我管理能力[健康行为能力自评量表(SRAHP)]。结果干预后,两组SGRQ、m MRC评分均低于干预前,且观察组低于对照组,差异有统计学意义(P<0.05)。干预后,两组SRAHP评分高于干预前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论行为分阶段转变理论的个案管理模式提高慢阻肺稳定期患者的自我管理能力,改善呼吸功能,具有较好应用效果。Objective To explore the application of the case management model based on the theory of phased behavior transformation in patients with stable period of chronic obstructive pulmonary disease(hereinafter referred to as“COPD”)at stable stage.Methods The prospective study included 112 patients with COPD in stable stage admitted to the outpatient department of Nanjing First Hospital from June 2021 to June 2022.They were divided into control group and observation group by random number table method,with 56 cases in each group.The control group was given the case management mode intervention,and the observation group was given the case management mode based on the theory of behavioral change in stages.Both groups were treated continuously for six months.Respiratory function before intervention and six months after intervention(St.George’s respiratory questionnaire[SGRQ]),(modified British Hospital Research Council dyspnea scale[mMRC])and(self-rated abilities for health practices scale[SRAHP])were compared.Results After intervention,SGRQ and mMRC scores in both groups were lower than before intervention,and the observation group was lower than the control group,the differences were statistically significant(P<0.05).After intervention,SGRQ and mMRC scores in both groups were lower than before intervention,and the observation group was lower than the control group,the differences were statistically significant(P<0.05).Conclusion The case management model of behavior stage change theory can improve the self-management ability and respiratory function of COPD patients in stable stage,and has a good application effect.

关 键 词：慢性阻塞性肺疾病 稳定期 行为分阶段转变理论 个案管理模式 呼吸功能 

分 类 号：R473[医药卫生—护理学]