基于两层三阶梯培训教育体系构建“三师共管”模式对COPD患者肺功能及自我管理能力的成效分析

The Effect Analysis of Self-management Ability and Pulmonary Function of COPD Patients Based on Two-tier and Three-step Training and Education System and Three-division Co-management Model

目的:分析基于两层三阶梯培训教育体系构建医师、护师、肺康复治疗师“三师共管”模式在慢性阻塞性肺疾病(COPD)患者肺康复推进中的应用成效,旨在改善患者肺功能,提高患者疾病自我管理能力,为COPD肺康复实践提供新视角。方法:纳入120例稳定期COPD患者作为研究对象,按入院时间分组;对照组(2018年1月1日~6月30日)52例行常规肺康复指导;观察组(2018年7月1日~12月31日)68例基于受教育程度、疾病严重程度分级两层面差异,对入院、在院、出院三阶段进行个体化培训,以“三师共管”管理新模式进行全程跟踪;比较两组肺功能及自我管理能力。结果:观察组出院时、复诊时肺功能各指标均优于对照组(P<0.05),干预后自我管理能力各维度评分均高于对照组(P<0.05)。结论:基于两层三阶梯培训教育体系构建“三师共管”模式,能改善患者肺功能,提高COPD患者自我管理能力。

Objective:To analysis the application effect based on two-tier and three-step training and education system of physicians,nurses,pulmonary rehabilitation therapist three division co-management model in pulmonary rehabilitation of patients with chronic obstructive pulmonary disease(COPD)to promote the application effect,aimed at improving patients with pulmonary function,promoting the patients′disease self-management ability,and providing a new perspective for the COPD pulmonary rehabilitation practices.Methods:A total of 120 patients with COPD in stable phase were included as the research objects and grouped into control group and observation group according to admission time.The control group(From January 1,2018 to June 30)with 52 patients were given routine pulmonary rehabilitation guidance,and the observation group(From July 1,2018 to December 31)with 68 cases were given individualized training in the three phases of admission,in-hospital,and discharged based on the level of education,and disease severity grade of two level difference.The observation group was followed up with the new management model of three division co-management through the whole process.Lung function and self-management ability were compared between the two groups.Results:Lung function indexes of the observation group were better than those of the control group at discharge and revisit(P<0.05),and scores of self-management ability after intervention were higher than those of the control group in all dimensions(P<0.05).Conclusion:The three-division co-management model based on the two-tier and three-step training and education system can improve the lung function of patients and promote the self-management ability of COPD patients.