医护患共享决策联合思维导图模式在老年慢性阻塞性肺疾病护理中的应用研究

Application Research of Shared Decision-making and Mmind Mapping Mode between Doctors,Nurses and Patients in Elderly Chronic Obstructive Pulmonary Disease Nursing

目的探讨医护患共享决策联合思维导图模式在老年慢性阻塞性肺疾病(COPD)护理中的应用效果。方法将我院2020年1月至2021年6月收治的172例老年COPD患者按随机数字表法分为对照组和观察组,每组86例,对照组给予常规护理干预,观察组给予医护患共享决策式护理联合思维导图护理干预,两组患者均干预8周,比较两组患者干预前后肺功能、疾病认知水平、自我护理能力、治疗依从性及生活质量差异,干预结束后随访3个月,统计再入院率情况。结果观察组治疗8周时FVC、FEV1、FEV1/FVC明显高于治疗前及对照组,P<0.05。观察组治疗8周时疾病知识、药物治疗、情绪管理、呼吸功能锻炼、健康生活方式认知评分明显高于治疗前及对照组,P<0.05。观察组治疗8周时自我护理维持、自我护理监测、自我护理管理评分明显高于治疗前及对照组,P<0.05。观察组治疗8周时治疗依从率明显高于治疗前及对照组,P<0.05。观察组治疗8周时SGRQ生活质量评分明显低于治疗前及对照组,P<0.05。对照组随访3个月再入院19例(22.09%),观察组再入院8例(9.30%),差异有显著性(P<0.05)。结论医护患共享决策联合思维导图模式在老年COPD护理中的应用能够提高患者疾病认知水平及自我护理能力,从而提高患者治疗依从性,有助于更好改善肺功能,提高患者生活质量,且能降低再入院率。

Objective To explore the effect of shared decision-making between doctors,nurses and patients combined with mind mapping model nursing in elderly patients with chronic obstructive pulmonary disease.Methods One hundred and seventy-two patients with chronic obstructive pulmonary disease admitted to our hospital from January 2020 to June 2021 were divided into control group and observation group according to random number table,86 cases of each group.The control group was given routine nursing intervention,the observation group was given shared decision-making nursing with nurses and patients combined with mind map nursing intervention.Both groups had been given intervention for 8 weeks.The lung function,disease cognition,self-care ability,treatment compliance and quality of life were compared between both groups before and after the intervention.The patients had been followed up for 3 months after the intervention,and the readmission rate was counted.Results The FVC,FEV1,FEV1/FVC of the observation group after 8 weeks of treatment were significantly higher than before treatment and after treatment in the control group,P<0.05.After 8 weeks of treatment,the scores of disease knowledge,drug treatment,emotional management,respiratory function exercise,and healthy lifestyle cognition in the observation group were significantly higher than those before treatment and after treatment in the control group,P<0.05.At 8 weeks of treatment,the scores of self-care maintenance,self-care monitoring and self-care management in the observation group were significantly higher than those before treatment and after treatment in the control group,P<0.05.The treatment compliance rate in the observation group at 8 weeks of treatment was significantly higher than that before treatment and after treatment in the control group,P<0.05.The SGRQ quality of life score in the observation group after 8 weeks of treatment was significantly lower than that before treatment and after treatment in the control group,P<0.05.In the control group,19 patients(22.09%)were readmitted after 3 months of follow-up,and 8 patients(9.30%)in the observation group were readmitted,the difference is significant(P<0.05).Conclusion The application of shared decision-making between doctors,nurses and patients combined with mind map nursing in elderly chronic obstructive pulmonary disease nursing can improve patients'disease cognition level and self-care ability,thereby improving patients'compliance with treatment,helping to better improve lung function and improve pulmonary function,quality of life of patients and reduce readmission rates.