健康促进模式在老年慢性阻塞性肺疾病患者健康教育中的应用

Application of health promotion model in elderly patients with chronic obstructive pulmonary disease

目的探讨健康促进模式(HPM)在老年慢性阻塞性肺疾病(COPD)患者中的应用及其对患者治疗依从性的影响。方法采用HPM对48例老年COPD患者进行系统、全面的健康教育;采用患者健康促进行为访谈提纲对患者进行个案分析;采用患者调查表评估患者的治疗依从性和入院率,并于1年后比较干预前后患者的入院率和治疗依从性。结果健康促进行为评估显示:48例患者均表示已经知道健康促进行为的益处,接受散步这一运动形式,但仍有19例未戒烟,2例来自重要他人的支持缺如;就诊太远是患者抱怨的主要原因,而嫌麻烦、认为没有必要来等主观因素也较明显,另有3例因工作原因可能影响其采取健康促进行为;全部患者能明确健康行为计划。通过1年健康教育,48例患者在遵医嘱服药、定期门诊随访和遵医嘱理疗三个方面的治疗依从性均较干预前显著提高(P<0.05),1年内入院人数明显降低(P<0.05)。结论 HPM作为原因模式可以协助临床护理人员分析影响患者健康促进行为的决定因素,有利于患者和护士共同制订健康行为计划,提高患者的自我管理意识和能力,明显改善患者的治疗依从性,降低患者入院率。

Objective To investigate the application of health promotion model(HPM) in elderly patients with chronic obstructive pulmonary disease(COPD),and evaluate its effect on therapy compliance of patients.Methods Systemic and comprehensive health education was conducted with HPM in 48 elderly patients with COPD.Health Promoting Interview Outline was employed for case analysis,Patient Therapy Questionnaire was utilized to assess the therapy compliance and admission rate of patients before intervention and one year after intervention.Results Health promotion behavior assessment indicated that all the 48 patients knew benefits of health promoting behaviors and accepted walking as the form of exercise,while 19 patients did not quit smoking,and 2 patients were lack of support from significant others.The main complaints of patients were the long distance from residence to hospital and the subjective ignorance,and the health promotion behavior of 3 patients was affected by working factors.All patients identified their health behavior programs.One year after intervention,the therapy compliance of patients significantly improved in the aspects of medicine taking,out-patient follow-up and physical therapy(P<0.05),and the admission rate significantly decreased(P<0.05).Conclusion Health education with HPM can improve the therapy compliance and decrease the admission rate of elderly patients with COPD.