自我管理与健康教育对COPD患者健康行为及康复的的应用价值

Application Value of Self Management and Health Education in the Health Behavior and the Rehabilitation of Patients with COPD

目的:探讨自我管理与健康教育对慢性阻塞性肺疾病(COPD)患者健康行为及康复的应用价值。方法:选取本院自2015年1月-2016年2月收治的75例COPD患者为观察对象,随机分为对照组与观察组,其中对照组37例,观察组38例。对照组给予常规健康教育,即指导型健康教育,观察组则实施自我管理与健康教育,通过成立一个多学科团队对患者进行教育,教育项目主要包括自我疾病正确认识、症状管理、自我情绪管理以及日常生活管理四个方面。两组患者均干预3个月,分别采用圣乔治呼吸疾病调查表(SGRQ)、健康行为测定量表(HPL)以及自我护理能力测定量表(ESCA)对两组患者进行测评。结果:干预3个月后,观察组呼吸道症状为(41.01±7.72)分、疾病影响为(40.93±9.04)分、活动受限为(44.25±8.96)分,均低于对照组的(47.31±9.26)分、(48.26±9.34)分、(51.26±10.49)分,差异均有统计学意义(P<0.05);观察组躯体活动为(22.54±3.86)分、心理健康为(23.10±3.12)分、健康责任感为(28.14±7.49)分、人际关系为(24.15±5.76)分、营养为(18.15±4.12)分、压力管理为(28.19±7.28)分,均分别高于对照组的(14.89±3.67)分、(13.99±3.56)分、(19.12±6.87)分、(17.14±4.56)分、(12.98±3.91)分、(21.02±6.30)分,差异均有统计学意义(P<0.05);观察组自我责任感为(47.10±7.35)分、自我护理能力为(106.45±16.04)分、自我概念为(20.02±2.91)分、自我护理技能为(28.14±5.81)分、健康知识水平为(21.20±4.30)分,均分别高于对照组的(39.14±6.71)分、(96.10±12.59)分、(18.06±2.11)分、(25.68±5.81)分、(19.04±4.19)分,差异均有统计学意义(P<0.05)。结论:加强COPD患者自我管理与健康教育,能够明显提高其自我护理能力,使其有效实施健康行为,对有效提高其生活质量,促进其康复有重大价值。

Objective： To study the application value of self management and health education in health behavior and the rehabilitation of patients with COPD.Method： From January 2015 to February 2016, 75 cases of COPD patients treated in our hospital were selected and divided into control group and observation group according to the random number table method.The control group had 37 cases, while the observation group had 38 examples.The control group was given routine health education, which was a health education guidance, while the observation group was implemented the self-management and health education, which through the formation of a muhidisciplinary team for patient education, the education projects mainly include disease correct understanding, symptom management, emotion management arid daily life management.All the patients were intervened 3 months, St George＇s respiratory questionnaire （ SGRQ ）, the measurement of health behavior scale （ HPL ） and self care ability measurement scale （ ESCA ） on the patients were evaluated.Result： After the intervention, the scores of the respiratory symptoms, disease impact, restricted movement in the observation group were respectively （ 41.01 ± 7.72 ）, （ 40.93 ± 9.04 ）, （ 44.25 ± 8.96 ）, were all lower than those of the control group （ 47.31 ± 9.26 ）, （ 48.26 ± 9.34 ）, （ 51.26 ± 10.49 ）, the differences were statistically significant （ P〈0.05 ） .The scores of the physical activity, psychological health, health responsibility, interpersonal relationship, nutrition, stress management in the observation group were （ 22.54 ± 3.86 ）, （ 23.10 ± 3.12 ）, （ 28.14 ± 7.49 ）, （ 24.15 ± 5.76 ）, （ 18.15 ± 4.12 ）, （ 28.19 ± 7.28 ）, were all higher than those of the control group （ 14.89 ± 3.67 ）, （ 13,99 ± 3.56 ）, （ 19.12 ± 6.87 ）, （ 17.14 ± 4.56 ）, （ 12.98 ± 3.91 ）, （ 21.02 ± 6.30 ）, the differences were statistically significant （P〈0.05） .The scores of the self-responsibility, self-care ability, self-concept, self-care skills, the level of health knowledge in the observation group were （ 47.10 ± 7.35 ）, （ 106.45 ± 16.04 ）, （ 20.02 ± 2.91 ）, 28.14 ± 5.81 ）, （ 21.20 ± 4.30 ） respectively, were all higher than those of the control group （ 39.14 ± 6.71 ）, （96.10 ± 12.59 ）, （ 18.06 ± 2.11 ）, （25.68 ± 5.81 ）, （ 19.04 ± 4.19 ）, the differences were statistically significant （ P〈0.05 ） .Conclusion： Strengthen the self-management and health education for the patients with COPD, well make sense to improve their self-care ability, promote the effective implementation of the health behavior, improve the quality of life and accelerate the rehabilitation.