TCM模式用于居家无创正压通气治疗COPD患者生活质量改善及再住院率控制效果观察

Effect of TCM in improving QoL and controlling rehospitalization rate for COPD patients treated with NPPV at home

目的探讨居家无创正压通气治疗慢性阻塞性肺疾病(COPD)患者护理中引入过渡期护理(TCM)模式的效果及价值。方法选取2019年4月至2021年5月在湖北省荆州市第一人民医院接受居家无创正压通气治疗的72例COPD患者,根据随机数表法分为两组。常规组(36例)治疗中行常规护理干预,干预组(36例)行TCM干预。干预时间均为6个月。观察患者生活质量改善、再住院率控制效果等情况。结果干预后,干预组过渡时间短于常规组,出院后6个月内再次住院为2.78%(1/36),低于常规组的16.67%(6/36),差异有统计学意义(t=5.829,χ^(2)=3.956,均P<0.05);干预后干预组用力肺活量(FVC)、用力呼气1 s容量(FEV_(1))及最大呼气峰流速值(PEF)相比常规组均明显更优,差异有统计学意义(t=8.741、7.121、4.623,均P<0.05);干预后干预组自我护理能力测定量表(ESCA)评分量表中自我概念、自我责任感、健康知识水平、自我护理技能评分相比常规组均更高,差异有统计学意义(t=15.436、22.430、19.991、9.114,均P<0.05);干预后与常规组比较,干预组生活质量评估中症状、活动受限及疾病影响评分均明显更低,差异有统计学意义(t=2.611、2.078、2.721,均P<0.05)。结论COPD患者居家接受无创正压通气治疗期间同时加强行TCM护理干预,可明显提高患者病情控制效果,降低其再住院率,促进患者生活质量改善。

Objective To explore the effect and value of the transitional care model(TCM)in the nursing of patients with chronic obstructive pulmonary disease(COPD)treated with non-invasive positive pressure ventilation(NPPV)at home.Methods A total of 72 COPD patients treated with NPPV at home after attending The First People’s Hospital of Jingzhou in Hubei Province from April 2019 to May 2021 were selected and evenly grouped into two groups according to the random number table method.The conventional group(n=36)received conventional nursing intervention,while the intervention group(n=36)received TCM intervention during treatment.Both groups were intervened for 6 months.The quality of life(QoL)improvement and the control of rehospitalization rate in all patients were observed.Results After the intervention,the transition time was shorter,and the rehospitalization rate within 6 months after discharge was lower in the intervention group(2.78%[1/36])than in the conventional group(16.67%[6/36]),with statistically significant differences(t=5.829,χ^(2)=3.956,both P<0.05).After the intervention,the forced vital capacity(FVC),forced expiratory volume in one second(FEV_(1)),and peak expiratory flow(PEF)in the intervention group were significantly batter than those in the conventional group(t=8.741,7.121,4.623,all P<0.05).The scores for self-concept,self-responsibility,health knowledge and self-care skills in the evaluation of self-care ability scale(ESCA)in the intervention group were all higher than those in the conventional group,with statistically significant differences(t=15.436,22.430,19.991,9.114,all P<0.05).After the intervention,the scores of symptoms,activity limitation and disease impact in the QoL assessment in the intervention group were significantly lower than those in the conventional group,with statistically significant differences(t=2.611,2.078,2.721,all P<0.05).Conclusion TCM intervention during the treatment of COPD patients with NPPV at home can significantly improve disease control,reduce rehospitalization rate,and promote the improve ment of QoL of patients.