医联体模式下呼吸内科专科护士共享在COPD患者延续护理中的应用

Application of specialist nurse sharing of Respiratory Medicine Department in transitional care of patients with chronic obstructive pulmonary disease under medical integration mode

目的探讨基于医联体模式下呼吸内科专科护士共享在COPD患者延续护理中的应用效果。方法采用便利抽样法选择2018年10月—2019年10月在新乡市中心医院呼吸科住院的134例COPD患者,随机分为对照组和观察组,各67例。对照组患者出院后实施常规管理,观察组患者出院后实施医联体模式下呼吸内科专科护士共享,为期1年。比较两组的BODE指数、COPD评估测试量表得分、1年内再次入院率和平均住院天数。结果干预后观察组的第1秒用力肺活量占预计值百分比(FEV1%)、6 min内步行距离(6MWT)高于对照组,且较干预前升高,差异均有统计学意义(P<0.05)。干预后观察组的mMRC评分、BODE指数和CAT得分低于对照组,且较干预前降低,差异均有统计学意义(P<0.05)。观察组和对照组1年内的再次入院率分别为23.88%、49.25%,两组比较差异有统计学意义(P<0.05);观察组患者1年内的平均住院天数短于对照组,两组比较差异有统计学意义(P<0.05)。结论采用医联体模式下呼吸内科专科护士共享模式对COPD患者进行延续护理可以有效缓解病情,改善生活质量,减少再次入院率,缩短平均住院时间。

Objective To explore effects of specialist nurse sharing of Respiratory Medicine Department in transitional care of patients with chronic obstructive pulmonary disease(COPD)under medical integration mode.Methods Using the convenient sampling method,a total of 134 COPD patients who were hospitalized in Respiratory Department of Xinxiang Central Hospital were selected from October 2018 to October 2019.They were randomly divided into the control group and the observation group,with 67 cases in each group.The patients in the control group were given routine management after they were discharged from the hospital,while patients in the observation group were given specialist nurse sharing of Respiratory Medicine Department under medical integration mode for a period of 1 year after they were discharged from the hospital.BODE index,COPD Assessment Test(CAT)scale score,readmission rate and average length of hospital stay within 1 year were compared between the two groups.Results After intervention,percent predicted of forced expiratory volume in first second(FEV1%Predicted)and Six-Minute Walk Test(6MWT)in the observation group were higher than those in the control group and higher than those before the intervention,and the differences were statistically significant(P<0.05).After the intervention,mMRC score,BODE index and CAT score of the observation group were lower than those of the control group and were lower than those before the intervention,and the differences were statistically significant(P<0.05).The readmission rate within 1 year of the observation group and the control group were respectively 23.88%and 49.25%,and the difference between the two groups was statistically significant(P<0.05).The average length of hospital stay within a year in the observation group was shorter than that in the control group,and the difference between the two groups was statistically significant(P<0.05).Conclusions Transitional care for COPD patients using specialist nurse sharing of Respiratory Medicine Department under medical integration mode can effectively alleviate the condition,improve quality of life,reduce the readmission rate and shorten the average length of hospital stay.