系统化健康管理对社区老年哮喘患者生活质量及自护能力的影响

Influence of systematic health management on quality of life and self-care ability in the elderly with asthma

目的探讨系统化健康管理对社区老年哮喘(AIE)患者生活质量及自护能力的影响。方法选取社区卫生服务中心收治并管理的110例社区AIE患者,随机分为干预组(n=55)和对照组(n=55)。对照组给予哮喘规范诊治,常规哮喘护理及健康指导,干预组通过组建社区综合管理团队,从建立哮喘专案、健康教育、心理干预及定期随访等方面对AIE患者进行系统化健康管理。采用圣乔治呼吸问卷(SGRQ)、自护能力测定量表(ESCA)评估生活质量和自护能力,随访6个月,记录患者的病情控制情况。结果干预后,两组SGRQ量表的症状、活动、影响评分及总评分均明显降低,干预组各维度的评分及总评分均显著低于对照组(P<0.05);干预后,干预组ESCA量表的自我概念、自护责任感、自护技能及健康知识水平均明显改善,且明显优于对照组(P<0.05);干预组发病次数、住院次数、医疗费用较对照组明显减少,住院时间也明显缩短(P<0.05)。结论系统性健康管理有助于提高社区AIE患者的生活质量和自护能力,降低哮喘复发风险,改善预后。

Objective To explore the effect of systematic health management on the quality of life and self-care ability in the elderly with asthma（ AIE）. Methods 110 community patients with AIE receiving treatment and management in community health service center were randomly divided into two groups. Control group（n =55）,received standard treatment,conventional asthma care and health guidance. Intervention group（n = 55） was given comprehensive management,including for^ning comprehensive management team, establishing project of asthma,health education,psychological intervention and regular follow-up. St Georges Respiratory Questionnaire （SGRQ） and Exercise of Self-care Ability Scale（ESCA） were used to assess the quality of life and self-care ability. All the patients were followed up for 6 months after intervention,the control of symptoms was recorded. Results After the implementation of intervention,the scores of symptoms, activities,influence and total score in SGRQ questionnaire in both groups were significantly reduced,and the scores of each dimension and total score in intervention group were significantly lower than those in control group（P 〈 0. 05）. After the implementation of intervention,the levels of self-concept, self-care responsibility, self-care skill and health knowledge in ESCA questionnaire in intervention group were significantly improved,and obviously better than those in control group（P 〈0.05）. Compared with control group,the frequency of onset and hospitalization,medical cost decreased significantly,the length of hospital stay was also significantly shortened（ P 〈0. 0 5 ） . Conclusion Systematic health management could contribute to improve the quality of life and self-care ability of patients with AIE,reduce the recurrence risk,and improve the prognosis.