社区护理干预对老年阻塞性肺疾病患者再住院和生活质量的影响

Effects of Community Nursing Intervention on Readmission and Quality of Life for Elderly Patients with Chronic Obstruction Pulmonary Disease

目的探讨社区护理干预对老年慢性阻塞性肺疾病患者再住院情况、病死率及生活质量的影响。方法将2008年1月至2009年1月的76例老年慢性阻塞性肺疾病患者按随机数字表法分为干预组和对照组各38例,对照组患者住院期间接受常规护理,干预组分别于出院前和出院后接受面对面干预和电话随访,内容包括劝导戒烟、心理支持、吸氧干预、呼吸功能训练、营养干预和症状识别等。比较两组患者出院后6个月的再住院次数、再住院天数、再住院率、病死率和生活质量评分。结果干预组患者的再住院天数和再住院次数少于对照组,再住院率低于对照组,生活质量的各维度评分低于对照组,差异均有统计学意义(P<0.05或P<0.01)。结论综合性的社区护理干预能提高患者对疾病的认识水平,使患者更好地配合医护人员的治疗护理工作,从而减轻患者的症状和减少急性发作,有助于减少医疗经费开支,提高患者的生活质量。

Objective To explore the effect of community nursing intervention on the readmission,fatality rate and quality of life（QOL） for elderly patients with chronic obstruction pulmonary disease（COPD）.Methods From January 2008 to January 2009,76 elderly hospitalized patients with COPD were randomly divided into intervention group（n=38） and control group（n=38）.The control group were given the routine nursing intervention during hospitalization.The intervention group were given prehospital face-to-face nursing interventions and after-discharge phone-call ones,including giving up smoking,psychology supporting,absorbing oxygen intervention,breathing function exercising,nutrition intervention and symptom distinguishing.Comparisons were conducted on the readmission times,hospital stay of readmission,readmission rate,fatality rate and QOL between the two groups six months after discharge.Results The hospital days and times of readmission of the intervention group were significantly less than those of the control group;the readmission rate in the intervention group was significantly lower than that of the control group;the scores of all dimensions of QOL in the intervention group were significantly lower than those of the control group（P〈0.05 or P〈0.01）.Conclusion Comprehensive community nursing intervention can enhance patients＇ awareness of disease and contribute to better nursing cooperation between patients and nurses,thus reducing the symptoms and acute episodes,helping reduce medical expenditure and improving patients＇ QOL.