同伴支持的护理干预对慢性阻塞性肺疾病患者呼吸功能与生活质量的影响

Effect of nursing intervention with peer support on respiratory function and life quality of patients with COPD

目的探讨同伴支持的护理干预对慢性阻塞性肺疾病(COPD)患者呼吸功能与生活质量的影响与效果。方法选择2018年1—10月在山东省枣庄市王开传染病医院内七科就诊的COPD患者79例.其中2018年1月至2018年5月进行常规护理干预的患者39例为对照组,2018年6月至2018年10月进行同伴支持的护理干预的患者40例为观察组。对照组采用常规护理干预;观察组在常规护理的基础上给予同伴支持的护理干预。比较干预后3个月两组患者的呼吸功能、生活质量及6min行走距离差异。结果干预后观察组第1秒用力呼气容积(FEV,)为(1.9±0.4)L,对照组为(1.5±0.3)L,两组比较差异有统计学意义(r=-4.16,P=0.000);观察组FEV,占预计值百分比(FEW%)为(65.2±6.6)%.对照组为(56.5±&7)%,两组比较差异有统计学意义Q=-5.20.P=0.000);观察组FEW与用力肺活量(FVC)比值(FEVj/FVC)为76.2+6.3.对照组为68.5±5.3,两组比较差异有统计学意义(r=—5.88.P=0.000)。干预后两组患者生活质量评分比较:观察组生理领域得分为(83.8±4.0)分、心理领域为(81.3+2.1)分、独立性领域为(82.3+2.5)分、社会关系领域为(80.5±2.5)分、环境领域为(87.3±2,4)分、精神/宗教领域为(84.5±2.6)分;对照组生理领域为(70.8±4.2)分、心理领域(为57.9+1.5)分、独立性领域为(70.5±2,3)分、社会关系领域为(69.9+2.3)分、环境领域为(72.9+2.4)分、精神/宗教领域为(70.5±2.8)分,两组6个领域得分差异均有统计学意义Q值分别为2.58,2.69,2.71.1.79,2.83,2.76,P值分别为0.023,0.021.0.018,0.029,0.014,0.016),6min步行距离实验(6-MWT);干预后观察组为(409.1±83.0)m.对照组为(363.9±81.8)m,两组比较差异有统计学意义(r=—2.45,P=0.016)。结论同伴支持的护理干预可以有效改善COPD患者的呼吸功能和生活质量。

Objective To explore the effect of nursing interventions with peer support on respiratory function and life quality of patients with chronic obstructive pulmonary disease (COPD). Methods A total of 79 COPD patients ? who visited No. 7 Department of Internal Medicine of Wangkai Infectious Disease Hospital from January to October 2018, were recruited in this study. Among them, 39 patients, who received routine nursing intervention from January to May 2018, were in the control group;while 40 patients, who received nursing intervention with on peer support from June to October 2018, were in the observation group. In the control group, the routine nursing interventions were provided to the patients while the nursing interventions with peer support based on routine nursing were given to the patients in the observation group. The difference of respiratory function, life quality and 6 min walking distance (6-MWD) of the patients in the two groups were compared after three-month interventions. Results After the interventions, FEV| of the patients in the observation group was (1. 9 + 0. 4) L while that was (1. 5士0. 3) L in the control group. There was significant difference between two groups (t=-4. 16, P = 0? 000). FEVi % of the patients in the observation group was (65. 2±6. 6)% while that was (56. 5zE8. 7)% in the control group. There was significant difference between two groups (t=-5. 20, P=0. 000). The value of FEVi/FVC of the patients in the observation group was 76. 2 i 6. 3 while that was 68. 5 + 5. 3 in the control group. There was significant difference between two groups (t=-5.88, P = 0. 000). After interventions, the QOL scores of the patienls in the two groups were compared and the results showed that the scores of physiological domain, psychological domain, independent domain, social relationship domai n, cnvironmenteil domain and spiritual/religious domain in the patients of observation group were 83. 8±4. 0,81. 3±2. 1,82. 3±2. 5, 80. 5 + 2. 5,87. 3±2. 4 and 84. 5 + 2. 6 respectively;while those were 70. 8 ± 4. 2, 57. 9 ± 1. 5, 70. 5 ± 2. 3, 69. 9 ± 2. 3 ,72. 9 ± 2. 4 and 70. 5 zt 2. 8 respectively in the patients of control group. There were significant difference in all six domains between the two groups (t= 2. 58, 2.69, 2. 71, 1.79, 2. 83, 2. 76 respectively: P = 0. 023, 0.021, 0.018, 0. 029. 0.014, 0.016 respectively). The 6-MWI) test result of the patients in the observation group was (409. 1 dz 83. 0) m while this value was (363. 9±81. 8) m in the patients of control group. There was significant difference between two groups (Z=-2. 45, P=0. 016). Conclusion Nursing intervenlions with peer support can effectively improve the respiratory function and life quality of COPD patients.