基于网络的自我管理模式在慢性阻塞性肺疾病患者中的应用研究

Effectiveness of internet-based self-management model in patients with chronic obstructive pulmonary disease

目的 探讨基于网络的自我管理模式对慢性阻塞性肺疾病患者自我管理行为的干预效果,为今后寻求并制定可操作性强、效果好的COPD患者自我管理模式提供参考。方法以2013年9月至2014年2月期间入住北京市某2所三级甲等医院呼吸科,经治疗后处于稳定状态的58例COPD患者为研究对象并按入院时间顺序分为实验组与对照组,实验组实施基于网络的自我管理模式干预,对照组采用常规出院指导,采用《慢性病自我管理行为测量表》比较干预前后两组自我管理行为的变化。结果 干预前58例COPD患者1周运动锻炼时间分布在0-108min,中位锻炼时间仅为33min,认知症状管理得分1.31±0.75,医患沟通得分1.23±0.74（0-5级评分）,两组自我管理行为得分差异无统计学意义（P〉0.05）。干预后结果显示：两组在认知症状管理与医患沟通维度自我管理行为差异有统计学意义（P〈0.05）,在周运动锻炼时间方面差异无统计学意义（P〉0.05）。结论 COPD患者自我管理行为较差,基于网络的自我管理模式是一种快速、有效提升COPD患者自我管理行为的干预手段。

Objective To evaluate the effectiveness of internet-based self-management model in patients with chronic obstructive pulmonary disease（COPD）, in order to provide reference for nurses to make further self- management intervention strategies. Methods Fifty-eight COPD patients in stable stage were divided into two groups according to admission time. Patients in the experimental group received internet-based self-management interven- tion, while patients in the control group received routine discharged guidance. Self-management Behaviors Ques- tionnaire was used to assess the self-management behaviors of COPD patients. Results There was no significant difference between two groups in the score of self-management behaviors（P〉0.05） before intervention. After intervention, the score of cognitive symptom management and physician-patient communication in the experimental group were significantly higher than those of the control group（P〈0.05）, while no significant difference was found in the exercise time between the two groups（P〉0.05）. Conclusion Self-management behaviors in COPD patients are insufficient, and internet-based self-management model may improve COPD patients＇ self-management effectively.