追踪随访教育对老年COPD合并呼吸衰竭患者自我效能感、自我护理能力及日常生活质量的影响

Influence of Follow-up Education on Self-efficacy,Self-care Ability and Daily Life Quality of Elderly Patients with COPD with Respiratory Failure

目的:探讨追踪随访教育对老年慢性阻塞性肺疾病(COPD)合并呼吸衰竭患者自我效能感、自我护理能力及日常生活质量的影响。方法:将收治的老年COPD合并呼吸衰竭患者80例为研究对象,均经治疗后病情稳定出院,按随机数字表法将其分为对照组和观察组各40例,对照组予以常规健康教育和出院指导,嘱患者出院后1、3个月到专科门诊随访复诊,观察组在对照组的基础上采用电话随访、短信提示等方式进行追踪教育和健康指导;分别于出院前和出院3个月后采用COPD自我效能感量表(CSES)、自我护理能力量表(ESCA)、圣乔治呼吸问卷(SGQR)评测两组的自我效能感、自我护理能力及生活质量。结果:出院3个月后,观察组CSES中负面影响、情绪激发、体力消耗、天气/环境、行为危险因素评分和总分明显高于出院前和对照组同期(P<0.05,P<0.01),对照组体力消耗评分明显高于出院前(P<0.05);出院3个月后,观察组ESCA中自我护理技能、自护责任感、自我概念、健康知识水平评分和总分明显高于出院前和对照组同期(P<0.05,P<0.01),对照组自护责任感和总分明显高于出院前(P<0.05);出院3个月后,观察组SGQR中各维度评分和总分显著低于出院前和对照组同期(P<0.05,P<0.01)。结论:追踪随访教育可以提高老年COPD合并呼吸衰竭患者的自我效能感、自我护理能力及日常生活质量。

Objective:To explore the influence of follow-up education on self-efficacy,self-nursing ability and daily life quality of elderly patients with chronic obstructive pulmonary disease(COPD)combined with respiratory failure.Methods:80 cases of senile COPD with respiratory failure patients were selected as the research objects,all of whom were discharged from hospital after treatment.According to random number table method,the research objects were divided into control group and observation group with 40 cases each.The control group was given routine health education and discharge guidance,and the patients were instructed to follow up and return to the specialist outpatient clinic 1 to 3 months after discharge.On the basis of the control group,the observation group adopted telephone follow-up,SMS prompts and other ways to conduct follow-up education and health guidance.COPD CSES,ESCA and SGQR were used to evaluate the self-efficacy,self-care ability and quality of life of the two groups before and 3 months after discharge,respectively.Results:Three months after discharge,the scores and total scores of negative influence,emotional stimulation,physical exertion,weather/environment,and behavioral risk factors in the CSES of the observation group were significantly higher than those of the control group before discharge and the same period of the control group( P <0.05, P <0.01),and the score of physical exertion in the control group was significantly higher than that before discharge( P <0.05).Three months after discharge,ESCA scores and total scores of self-care skills,self-responsibility,self-concept and health knowledge in the observation group were significantly higher than those before discharge and at the same period in the control group( P <0.05, P <0.01),while the total score and self-responsibility of the control group were significantly higher than those before discharge( P <0.05).Three months after discharge,SGQR scores and total scores in the observation group were significantly lower than those before discharge and at the same periodin in the control group( P <0.05, P <0.01).Conclusion:Follow-up education can improve the self-efficacy,self-care ability and daily life quality of elderly patients with COPD combined with respiratory failure.