Donabedian质量理论对慢阻肺患者护理质量提升作用的研究

Study on promotion effect of Donabedian quality theory on nursing quality in patients with chronic obstructive pulmonary disease

目的研究Donabedian质量理论对慢阻肺(COPD)患者护理质量的提升作用。方法于2018年28期间采用随机抽样法选取入住本院的老年COPD患者,根据Donabedian质量理论制定出院COPD患者的延续护理的方案;针对整个延续护理方案的各个项目从结构、过程、结果三个方面进行评价,以确保整个方案的有效落实,最后采用SGRQ、6MWT、血气指标及肺功能指标变化情况来评价延续性护理方案对COPD患者生活质量及身体状况的改善效果。结果COPD患者在干预后的6MWT高于干预前的[(355.43±26.78)m比(256.37±18.25)m;(P<0.05)];COPD患者干预后SGRQ中呼吸症状、活动受限、疾病影响、总分均显著低于干预前[(25.44±12.51)分比(50.33±15.48)分,(45.39±15.49)分比(68.47±17.41)分,(24.82±12.13)分比(45.03±16.84)分,(32.43±10.62)分比(57.39±15.57)分],干预前后比较差异均有统计学意义(均P<0.05);COPD患者干预后的PCO2显著低于干预前([45.34±6.19)mmHg比(58.42±8.98)mmHg],PO2、FEV1、FEV1/FVC、FVE 1%pred显著高于干预前[(71.52±8.31)mmHg比(55.79±5.72)mmHg,(2.97±1.19)L比(1.84±0.98)L,(69.43±10.19)%比(47.52±9.38)%,(98.34±10.29)%比(41.24±5.88)%],干预前后比较差异均有统计学意义(均P<0.05)。结论根据Donabedian质量理论框架制定的护理方案有效的提高了COPD患者的护理质量,能更好的改善COPD患者的生活质量及身体状况。

Objective To study promotion effect of Donabedian quality theory on nursing quality in patients with chronic obstructive pulmonary disease(COPD).Methods According to Donabedian quality theory,the continuing nursing plan for discharged COPD patients was formulated.The evaluation was conducted from structure,process,and results aspects aimed at each item of entire continuing nursing plan to ensure effective implementation of entire plan.Finally,St.George's Respiratory Questionnaire(SGRQ),6-minute walk test(6MWT),changes in blood gas indexes and lung function indexes were performed to evaluate improvement effects of Donabedian quality theory on quality of life and physical condition in COPD patients.Results The 6MWT of COPD patients after the intervention was significantly higher than that before the intervention[(355.43±26.78)m vs.(256.37±18.25)m](P<0.05).The scores of respiratory symptoms,activity limitation,and disease effects,and the total score of SGRQ of COPD patients after the intervention were significantly lower than those before the intervention[(25.44±12.51)vs.(50.33±15.48),(45.39±15.49)vs.(68.47±17.41),(24.82±12.13)vs.(45.03±16.84),(32.43±10.62)vs.(57.39±15.57)](P<0.05).After the intervention,partial pressure of carbon dioxide(PCO2)of COPD patients was significantly lower than that before the intervention[(45.34±6.19)vs.(58.42±8.98)](P<0.05),while partial pressure of oxygen(PO2),forced expiratory volume in 1 second(FEV1),FEV1/forced vital capacity(FEV1/FVC),and FEV1 as a percentage of predicted value(FEV1%)were significantly higher than those before the intervention[(71.52±8.31)vs.(55.79±5.72),(2.97±1.19)vs.(1.84±0.98),(69.43±10.19)vs.(47.52±9.38),(98.34±10.29)vs.(41.24±5.88)](P<0.05).Conclusion The nursing plan based on Donabedian quality theory framework effectively improve nursing quality in COPD patients,which can better improve quality of life and physical condition of COPD patients.