循证护理提高慢性阻塞性肺疾病患者无创正压通气依从性的实践

Evidence-based nursing on improving compliance of COPD patients with noninvasive positive pressure ventilation

目的探讨循证护理提高慢性阻塞性肺疾病（chronic obstructive pulmonary disease,COPD）患者无创正压通气（non-invasive positive pressure ventilation,NIPPV）依从性的实践效果。方法将2014年1~6月收治的45例COPD患者设为对照组,将2014年7~12月收治的45例COPD患者设为实验组。对照组患者在NIPPV治疗期间采用传统护理方法;实验组成立循证护理小组,通过现状调查,了解导致COPD患者NIPPV治疗期间不依从原因,并对问题进行循证,寻找最佳的证据,结合患者情况给予最佳的护理措施。比较两组患者NIPPV治疗期间不良反应发生及治疗依从性情况。结果两组患者恐惧、焦虑,人机不协调造成呼吸抵抗、胃肠胀气不良反应及治疗依从性情况比较,均P〈0.05,差异具有统计学意义,实验组患者不良反应发生率明显低于对照组,治疗依从性明显高于对照组。结论应用循证护理能有效提高COPD患者NIPPV治疗期间治疗依从性,而且能减少不良反应。

Objective To explore the effect of evidence-based nursing on improving the compliance of chronic obstructive pulmonary disease （COPD） patients with noninvasive positive pressure ventilation. Methods Forty-five patients hospitalized in the first half of the year were assigned as control group and another 45 patients hospitalized in the second half of the year were as experiment group. The control group was treated with traditional nursing methods. In the experiment group, a nursing panel was set up to analyze the causes of noncompliance of COPD patients with noninvasive positive pressure ventilation and gave care to the patients based on the analyses. The two groups were compared in terms of adverse reactions and the compliance with treatment. Result The rates of compliance with treatment and adverse reactions such as fear and anxiety, the man -machine confrontation and flatulence in the experiment group were significantly lower than those of the control group obviously （P 〈 0.05）. Conclusion The evidence-based nursing can reduce the incidence of adverse reactions, and enhance the compliance of COPD patients with noninvasive positive pressure ventilation effectively.