优质护理项目“哮喘之家”对哮喘患儿院外随访干预效果的影响

The effect of “asthma home” of nursing care on asthma children outside the hospital

目的:探讨优质护理项目“哮喘之家”对哮喘患儿院外随访干预效果的影响。方法:选取2015年11月至2016年12月在安徽省宿州市立医院就诊的100例哮喘患儿,随机分为观察组和对照组,每组50例,对照组给予常规出院指导,观察组出院后进入“哮喘之家”管理,推广“机会窗”控制法、家访排查致喘因素、个体化呼吸功能锻炼和关注高发期预防。比较两组出院时和出院1年后哮喘认知程度、操作技术、服药依从性和哮喘发作次数,儿童哮喘控制测试评分(CACT)和哮喘患儿生活质量问卷(PAQLQ)评分。结果:观察组出院后1年哮喘发作次数少于对照组,CACT得分、PAQLQ得分均明显高于对照组,差异均有统计学意义(均P<0.01);Pearson相关分析显示:知识技能得分与医疗效果得分(CACT得分、PAQLQ得分)均呈正相关关系(r=0.999、0.554和0.815,均P<0.01);CACT总分与PAQLQ总分亦呈正相关关系(r=0.713,P<0.01)。结论:优质护理项目“哮喘之家”能提高“机会窗”的认知程度,方便及时用药,改善哮喘患儿的生活质量。

Objective: To explore the effect of “asthma home” of nursing care on asthma children outside the hospital. Methods: From November 2015 to December 2016,a total of 100 children with asthma in our hospital were selected,and randomly divided into an observation group and a control group,with 50 cases in each group.The children in the control group received routine discharge guidance,while those in the observation group received “asthma home” management plan at discharge.The management plan aimed to identify threatened symptoms and the asthmatic factors,promote individualized respiratory function training and focus on the prevention during high-incidence period.The asthma awareness,the skill score of home nursing care,medication compliance,asthma attacks,childhood asthma control test (CACT) score and Pediatric Asthma Quality of Life Questionnaire (PAQLQ) score at discharge and one year after discharge were compared between two groups. Results: After one year,the attacks of asthma was reduced while the CACT and PAQLQ scores were elevated in the observation group compared with the control group ( P <0.01).Pearson correlation analysis showed that the knowledge and skills of home nursing care score was positively correlated with the CACT and PAQLQ scores ( r =0.999,0.554 and 0.815, P <0.01).There was also a positive correlation between CACT score and PAQLQ score ( r =0.713, P <0.01). Conclusion:“Asthma home” management of nursing care could improve the awareness of the “opportunity window”,facilitate timely medication and improve the life quality of children with asthma.