5A护理模式在肺源性心脏病临床治疗中的应用

Application of 5A nursing mode in the treatment of patients with pulmonary heart disease

目的探讨5A护理模式(询问、建议、评估、帮助与随访)在肺源性心脏病临床治疗中的应用效果.方法将76例肺源性心脏病患者按随机数字表法分为两组,每组38例.两组均予以常规治疗,在此基础上对照组予以常规护理干预,研究组采用5A护理模式实施干预.观察3个月.于干预前后,检测肺功能(用力呼气峰流量、第1 s用力呼气容积、第1 s用力呼气容积占用力肺活量百分比)及血气分析指标(氧气分压、二氧化碳分压及动脉血氧饱和度),采用尼古丁依赖检测量表评定患者对尼古丁的依赖程度.随访12个月统计患者的戒烟情况.结果干预前两组肺功能、血气分析各项指标比较差异无统计学意义(P>0.05);干预后两组肺功能、血气分析各项指标较干预前均显著改善(P<0.01),研究组显著优于对照组(P<0.01).干预前两组尼古丁依赖检测量表评分评分比较差异无统计学意义(P>0.05);干预后两组尼古丁依赖检测量表评分较干预前显著降低(P<0.05或0.01),研究组显著低于对照组(P<0.01).研究组近期、中期戒烟成功率显著高于对照组(P<0.05).结论5A护理模式应用于肺源性心脏病临床治疗可明显缓解患者对烟草的依赖性,提高戒烟成功率,有效改善患者肺功能.

Objective To explore the application of 5A nursing mode(ask,advice,assess,assist and arrange)in the treatment of patients with pulmonary heart disease.Methods 76 cases of PHD were randomly divided into two groups,38 cases in each group.On this basis,the control group received routine nursing intervention,and the study group received 5A nursing intervention for 3 months.Before and after intervention,lung function(PEF,FEV1,FEV1/FVC)and blood gas analysis index(PO2,PCO2,SaO2)were measured,and FTND was used to assess the patients dependence on nicotine.Smoking cessation was followed up for 12 months.Results The pulmonary function indexes and blood-gas analysis index before intervention showed no significant difference between the two groups(P>0.05);those indexes after intervention were significantly improved in comparison of before intervention(P<0.01),and the improvement degree in the study group was significantly higher than that of control group(P<0.01).FTND scores showed no significant differences between the two groups before intervention(P>0.05).After the intervention,the FTND scores of the two groups were significantly lower than those before the intervention(P<0.05 or 0.01),and the study group was significantly lower than the control group(P<0.01).The success rate o￡near-term,medium-term smoking cessation in the study group was significantly higher than that in the control group(P<0.05).Conclusions The 5A nursing model can applied to the clinical treatment of pulmonary heart disease,which can significantly alleviate the dependence of patients on tobacco,improve the success rate of smoking cessation,and effectively improve the lung function of patients.