保护动机理论指导下的自护行为护理对COPD患者的影响

Effect of Self-care Behavior Nursing Based on Protection Motivation Theory in COPD Patients

目的:探讨保护动机理论(PMT)指导下的自护行为护理对慢性阻塞性肺疾病(COPD)患者的影响。方法:选择2018年6月1日~2020年6月30日就诊的106例COPD患者,根据随机数字表法分为观察组和对照组各53例,对照组采用常规护理,观察组采用PMT指导下的自护行为护理;比较两组干预前后的自我管理能力、肺功能[包括第一秒用力呼气容积(FEV)及第一秒用力呼气容积占其预计值的百分比(FEV/FVC%)]、运动能力[采用6分钟步行试验(6MWT)]、生活质量[采用COPD生活质量评估量表(CAT)]及呼吸困难程度[采用呼吸困难评价量表(mMRC)]、负性情绪[采用焦虑自评量表(SAS)及抑郁自评量表(SDS)],并记录呼吸道感染、因症再住院情况及护理满意度。结果:干预后,两组症状管理、日常生活管理、自我效能、信息管理、情绪管理得分均高于干预前(P<0.05),且观察组高于对照组(P<0.01,P<0.05);干预后,两组FEV、FEV/FVC%、6MWD均优于干预前(P<0.05),且观察组优于对照组(P<0.01);干预后,两组CAT、mMRC、SAS、SDS评分均低于干预前(P<0.05),且观察组低于对照组(P<0.01);观察组呼吸道感染、因症再住院率均低于对照组(P<0.05),护理满意度高于对照组(P<0.01)。结论:PMT指导下的自护行为护理能提高COPD患者的自我管理能力,改善其肺功能及运动能力,从而有效控制病情,提高患者生活质量,缓解其不良情绪,并降低患者的呼吸道感染及因症再住院率,提高护理满意度。

Objective: To explore the effect of self-care behavior nirsing based on protection motivation theory(PMT)in patients with chronic obstructive pulmonary disease(COPD).Methods: A total of 106 patients with COPD treated during June 1,2018 to June 30,2020 were selected and were divided into the observation group and the control group according to the random number table method, 53 cases in each group.The control group was given routine nursing, while the observation group was given PMT-based self-care behavior nursing.The self-management ability, pulmonary function including the first second forced expiratory volume(FEV)and the first second forced expiratory volume in the percentage of its expected value(FEV/FVC%),motor ability by 6 minute walking test(6 MWT),quality of life by COPD quality of life scale(CAT),breathing difficulty by dyspnea assessment scale(mMRC),negative emotions by the Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDA)between the two groups were compared before and after intervention.The respiratory infection, re-hospitalization status and nursing satisfaction were recorded.Results: After intervention, the symptoms management, daily life management, self-efficacy, information management and emotional management scores in both groups were higher than those before intervention(P<0.05),and those in the observation group were higher than those in the control group(P<0.01,P<0.05).After intervention, the FEV,FEV/FVC% and 6 MWD in both groups were better than those before intervention(P<0.01),and were better in the observation group than those in the control group(P<0.01).After intervention, the CAT,mMRC,SAS and SDS scores in both groups were lower than those before intervention(P<0.05),and were lower in the observation group than those in the control group(P<0.01).The incidence of respiratory infection and re-hospitalization in the observation group was lower than that in the control group(P<0.05),and the nursing satisfaction was higher than that in the control group(P<0.01).Conclusion: The self-care behavior nursing based on PMT can improve the self-management ability, pulmonary function and motor ability in COPD patients, thereby effectively control their disease conditions, improve their quality of life and negative emotions, and reduce the incidence of respiratory infection and re-hospitalization, with good nursing satisfaction.