优质干预模式对慢性阻塞性肺疾病急性加重期并发呼吸衰竭患者治疗效果及家属疾病不确定感的影响

Effect of quality intervention model on patients with acute exacerbation of COPD complicated with respiratory failure and disease uncertainty of family members

目的:研究优质干预模式对急性加重期慢性阻塞性肺疾病(COPD)并发呼吸衰竭患者治疗效果及家属疾病不确定感的影响。方法:对我院在2015年6月-2018年6月诊治的COPD急性加重期并发呼吸衰竭患者146例展开研究,采用随机数字表法分为观察组与对照组各73例。对照组采取常规干预方式,观察组给予优质干预模式。随访4周后;采取疾病不确定感家属量表对患者家属进行评估,对比分析两组干预前后的应对方式和肺功能指标,观察其经济学指标及干预满意度情况。结果:观察组干预后肺功能(PEF、FVC及FEV1)指标水平均显著高于对照组(t=7.710,6.042,9.083;P<0.001);两组干预前的MCMQ评分中面对及回避、屈服比较均无统计学意义(P>0.05);观察组干预后的MCMQ评分中面对得分高于对照组,屈服、回避得分低于对照组(t=3.622,-6.156,-6.388;P<0.001);观察组患者住院费用及总住院时间均低于对照组(t=-14.634,-12.197;P<0.001),干预后的满意度高于对照组(t=3.520,P<0.001);两组患者家属干预前的疾病不确定性、不可预测性、不明确性、复杂性、信息缺乏性得分比较无统计学意义(P>0.05),观察组患者家属干预后的疾病不确定感各指标均明显低于对照组(t=-23.025,-23.215,-20.080,-21.561,-16.645;P<0.001)。结论:优质干预模式能有效的降低COPD急性加重期并发呼吸衰竭患者家属疾病的不确定感,改善其肺功能,提高应对能力及干预满意度,促进患者快速康复。

Objective:To investigate effect of quality intervention model on disease uncertainty of family members of patients with acute exacerbation of chronic obstructive pulmonary disease(COPD)complicated with respiratory failure.Methods:A total of 146 patients with acute exacerbation of COPD complicated with respiratory failure in our hospital from June 2015 to June 2018 were selected and divided into two groups according to the random number table methods,each with 73 cases.The control group was given routine intervention,while the observation group was given high-quality intervention mode,and both groups were followed up for 4 weeks.Then the disease uncertainty of family members,coping styles,pulmonary function indexes,economic indicators and intervention satisfaction degree were observed and compared.Results:The levels of pulmonary function indexes(PEF,FVC and FEV1)in the observation group were significantly higher than those in the control group after intervention(t=7.710,6.042,9.083,P<0.001);The scores of coping styles including face,avoidance and yielding in MCMQ scale before intervention had no difference between the two groups(P>0.05),after intervention,the face coping style scores were higher in the observation group than that in the control group,and the score of avoidance and yielding coping style were lower in the observation group than that in the control group(t=3.622,-6.156,-6.388;P<0.001).The hospitalization expenses and total hospitalization time of the observation group patients were lower than those of the control group(t=-14.634,-12.197;P<0.001).The satisfaction degree of the observation group after intervention was higher than that of the control group(t=3.520,P<0.001).The scores of disease uncertainty,unpredictability,ambiguity,complexity,and information deficiency before intervention had no difference between the two groups(P>0.05),which were lower in the observation group than that in the control group after intervention(t=-23.025,-23.215,-20.080,-21.561,-16.645;P<0.001).Conclusion:The application of quality intervention model can effectively ameliorate the disease uncertainty of family members,pulmonary function,coping ability and intervention satisfaction degree,as well as can promote the recovery for patients with acute exacerbation of COPD complicated with respiratory failure.