健康信念模式理论联合肺康复训练对AECOPD患者肺功能及生活质量的影响

Effect of health belief model theory and lung rehabilitation exercise intervention on pulmonary function and quality of life in AECOPD patients

目的:研究健康信念模式理论联合肺康复训练对慢性阻塞性肺疾病急性加重(AECOPD)患者肺功能及生活质量的影响。方法:回顾性研究。选择2019年11月至2020年4月上海市金山区亭林医院收治的114例的AECOPD患者,分为对照组和观察组,每组57例。对照组进行常规肺康复训练,观察组在肺康复训练的基础上加用健康信念模式教育进行干预,为期4周。COPD认知问卷评价2组患者治疗前后的认知水平,呼气峰流速(PEF)、第1秒用力呼气容积占预计值百分比(FEV 1%pred)衡量肺功能,改良版英国医学研究委员会呼吸困难量表(mMRC)评估呼吸困难,SF-36评估生活质量,FS-14评价患者的疲劳情况。结果:干预后2组患者对COPD的认知水平、肺康复锻炼得分均提高,且观察组的上述指标得分均显著高于对照组,差异均有统计学意义(P值均<0.05);干预后2组患者PEF和FEV 1%pred均提高,且观察组均高于对照组,差异均有统计学意义(P值均<0.05);干预后2组mMRC评分下降,且观察组低于对照组,差异均有统计学意义(t=2.297,P<0.05);干预后2组SF-36各维度得分均升高,且观察组得分均高于对照组,差异均有统计学意义(P值均<0.05);干预后2组FS-14评分均降低,且观察组躯体疲劳和总分均低于对照组,差异均有统计学意义(P值均<0.05)。结论:健康信念模式理论联合肺康复训练能提高AECOPD患者对疾病的认知水平,改善肺功能,提高生活质量。

Objective:To analyze the clinical effect of health belief model theory combined with lung rehabilitation exercise intervention on the pulmonary function and quality of life in acute exacerbation of chronic obstructive pulmonary disease(AECOPD)patients.Methods:A total of 114 cases of AECOPD patients in Shanghai Jinshan Tinglin Hospital from November 2019 to April 2020 were selected for retrospective study,and they were randomly divided into control group and observation group,each group with 57 cases.The control group got routine lung rehabilitation exercise,while the observation group got health belief model education combined with lung rehabilitation exercise training for 4 weeks.Questionnaires were used to evaluate the cognitive level of COPD before and after intervention.Pulmonary function was evaluated by peak expiratory flow(PEF)and forced expiratory volume in the first second in percent predicted values(FEV 1%pred).Dyspnea was assessed by modified Medical Research Council(mMRC).Quality of life was assessed by SF-36 score.Fatigue Scale-14(FS-14)was used to assess the fatigue level.Results:After intervention,the scores of COPD basic knowledge and lung rehabilitation exercise were significantly improved in both groups,and the scores in the observation group were significantly higher than those in the control group(both P<0.05).PEF and FEV 1%pred were increased significantly in both groups,while it was significantly higher in the observation group than the control group(both P<0.05).The mMRC scores and FS-14 scores were decreased significantly in both groups,while they were significantly lower in observation group than control group(both P<0.05).The SF-36 score was increased in both groups,while it was significantly higher in observation group than in control group(both P<0.05).Conclusions:Health belief model theory combined with lung rehabilitation exercise intervention can improve AECOPD patients′awareness of disease,improve pulmonary function and improve the quality of life.