医养结合模式下的延续性护理对慢性阻塞性肺疾病患者肺功能、营养指标及心理状态的影响

Effects of Continuous Nursing Based on Combination of Medical Care and Nursing on Pulmonary Function,Nutritional Index and Psychology of Patients with Chronic Obstructive Pulmonary Disease

目的探讨医养结合模式下的延续性护理对慢性阻塞性肺疾病(COPD)患者肺功能、营养指标及心理状态的影响。方法选取武汉市金银潭医院呼吸内科2018—2019年收治的COPD患者86例,随机分为对照组和观察组,每组43例。对照组患者采用常规健康教育,观察组患者在对照组基础上给予医养结合模式下的延续性护理。比较两组患者肺功能指标[第1秒用力呼气容积(FEV1)、用力肺活量(FVC)、FEV1/FVC、峰值呼气流速(PEF)、最大呼气中期流量(MMEF)]、6 min步行距离(6MWD)、营养相关指标[体质指数(BMI)、血红蛋白(Hb)、血清白蛋白(Alb)、总蛋白(TP)]、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分及自我感受负担量表(SPBS)评分。结果观察组患者干预后6、12个月FEV1、FVC、FEV1/FVC、PEF、MMEF高于对照组,6MWD长于对照组(P<0.05)。观察组干预后患者BMI、Hb、Alb及TP高于对照组(P<0.05)。观察组患者干预后SAS、SDS及照顾负担、情感负担评分低于对照组(P<0.05)。结论医养结合模式下的延续性护理能够有效改善COPD患者肺功能及营养状况,增强运动耐量,缓解负性情绪,减轻自我负担。

Objective To explore the effects of continuous nursing based on combination of medical care and nursing on pulmonary function,nutritional index and psychology of patients with COPD.Methods From 2018 to 2019,86 cases of patients with COPD were selected in Wuhan Jinyintan Hospital,and they were randomly divided into the control group and the observation group,43 cases in each group.Patients in the control group were given routine health education,patients in the observation group were given continuous nursing based on combination of medical care and nursing.Pulmonary function indexes(FEV1,FVC,FEV1/FVC,PEF,MMEF),6 MWD,nutritional indexes(BMI,Hb,Alb,TP)and scores of SAS,SDS,SPBS were compared between the two groups.Results At 6 and 12 months after intervention,FEV1,FVC,FEV1/FVC,PEF,MMEF in the observation group were higher than those in the control group,6 MWD was longer than that in the control group(P<0.05).BMI,Hb,Alb,TP in the observation group were higher than those in the control group after intervention(P<0.05).Scores of SAS,SDS and care burden,emotional burden in the observation group were lower than those in the control group after intervention(P<0.05).Conclusion Continuous nursing based on combination of medical care and nursing can improve pulmonary function and nutritional situation of COPD patients,enhance exercise tolerance,relieve negative emotions,and reduce self-burden.