动机性访谈对老年COPD患者肺功能、呼吸锻炼行为以及依从性的影响

Effect of motivational interview on pulmonary function,respiratory exercise behavior and compliance of elderly COPD patients

目的探讨动机性访谈对老年慢性阻塞性肺疾病(COPD)患者肺功能、呼吸锻炼行为以及依从性的影响。方法98例老年COPD患者,根据收治时间不同分为观察组与对照组,每组49例。对照组给予常规心理护理,观察组在对照组的基础上给予基于跨理论模型的动机性访谈干预。比较两组呼吸锻炼行为阶段改变、呼吸锻炼依从性、肺功能[用力肺活量(FVC)、第1秒用力呼气容积(FEV1)、第1秒用力呼气容积/用力肺活量(FEV1/FVC)、呼气峰值流速]指标。结果干预后,两组患者呼吸锻炼行为阶段均较干预前改善,且观察组较对照组改善明显,差异有统计学意义(P<0.05)。观察组呼吸锻炼依从性高于对照组,差异有统计学意义(P<0.05)。观察组的FVC、FEV1、FEV1/FVC、呼气峰值流速分别为(2.21±0.52)L、(1.62±0.22)L、(73.30±9.21)%、(358.23±27.12)L/min;对照组分别为(1.78±0.64)L、(1.01±0.29)L、(56.74±10.32)%、(325.17±30.45)L/min;两组FVC、FEV1、FEV1/FVC、呼气峰值流速均较干预前改善,且观察组改善优于对照组,差异有统计学意义(P<0.05)。结论基于跨理论模型的动机性访谈可以激发患者内在的行为改变动机,增强其呼吸锻炼的意愿,提高其呼吸锻炼的依从性,从而有效的改善患者的肺功能。

Objective To discuss the effect of motivational interview on pulmonary function,respiratory exercise behavior and compliance of elderly chronic obstructive pulmonary disease(COPD)patients.Methods A total of 98 elderly COPD patients were divided into observation group and control group by different visiting time,with 49 cases in each group.The control group received conventional psychological nursing,and the observation group received motivational interview intervention on the basis of trans-theoretical model.The change in respiratory exercise behavior stage,compliance of respiratory exercise,pulmonary function[forced vital capacity(FVC),forced expiratory volume in 1 second(FEV1),FEV1/FVC]and peak expiratory velocity]were compared between the two groups.Results After intervention,the stage of respiratory exercise behavior in the two groups was improved compared with that before intervention,and the respiratory exercise behavior in the observation group was significantly better than that in the control group,and the difference was statistically significant(P<0.05).The compliance of respiratory exercise of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).FVC,FEV1,FEV1/FVC,peak expiratory velocity of the observation group were(2.21±0.52)L,(1.62±0.22)L,(73.30±9.21)%and(358.23±27.12)L/min respectively,which were(1.78±0.64)L,(1.01±0.29)L,(56.74±10.32)%and(325.17±30.45)L/min of the control group.FVC,FEV1,FEV1/FVC,peak expiratory velocity of the two groups were improved compared with those before intervention,and the observation group was better than those of the control group,and the difference was statistically significant(P<0.05).Conclusion The motivational interview based on the trans-theoretical model can stimulate the patients i’ntrinsic motivation of behavior change,enhance their willingness of respiratory exercise,improve their compliance with respiratory exercise,thus effectively improving their pulmonary function.