基于慢性病轨迹模式的干预在COPD患者中的应用效果观察

The Application Effect of Chronic Illness Trajectory Model-based Intervention on COPD

目的探讨基于慢性病轨迹模式的干预在慢性阻塞性肺疾病(COPD)患者中的应用效果。方法2020年1月至2022年7月,采用方便抽样方法选取江苏省扬州洪泉医院收治的89例COPD患者作为研究对象,根据门诊挂号单双号将其分为对照组(n=44)和观察组(n=45)。对照组接受常规护理干预,观察组接受基于慢性病轨迹模式的干预。分别于入院时(干预前)和出院前(干预后),比较两组患者的BODE指数、改良呼吸困难指数(mMRC)、第1秒用力呼气量(FEV1)、用力肺活量(FVC)、最大呼气中段流量(MMEF)、动脉血氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))、血液pH值和血氧饱和度(SaO_(2))、自我管理能力(AHSMSRS)及生活质量(SGRQ)。结果干预后,观察组患者BODE指数、FEV1、FVC、MMEF、PaO_(2)、SaO_(2)、血液pH和AHSMSRS得分均优于对照组(P<0.05),mMRC、PaCO_(2)和SGRQ得分均低于对照组(P<0.05)。结论基于慢性病轨迹模式的干预可帮助COPD患者改善肺功能及血气指标,提升自我管理能力与生活质量,值得临床推广。

Objective To explore the application effect of chronic illness trajectory model-based intervention on chronic obstructive pulmonary disease(COPD).Methods From January 2020 to July 2022,a total of 89 COPD patients who were admitted to Yangzhou Hongquan Hospital in Jiangsu Province were selected by convenience sampling.They were divided into the control group(n=44)and the observation group(n=45)by their odd/even outpatient registration numbers.Patients in the control group were given routine nursing intervention,while those in the observation group were given chronic illness trajectory model-based intervention.BODE index,dyspnea index(modified Medical Research Council),forced expiratory volume in the first second(FEV1),forced vital capacity(FVC),maximal mid-expiratory flow(MMEF),partial pressure of oxygen in arterial blood(PaO_(2)),partial pressure of carbon dioxide(PaCO_(2)),blood pH,oxygen saturation(SaO_(2)),self-management skills(the Rating Scale of Health Self-management Skill for Adults)and quality of life(St.George's Respiratory Questionnaire)were compared between the two groups at admission(before intervention)and before discharge(after intervention)respectively.Results After the intervention,the BODE index,FEV1,FVC,MMEF,PaO_(2),SaO_(2),blood pH and AHSMSRS scores in the observation group were all superior to those in the control group(P<0.05);the mMRC,PaCO_(2) and SGRQ scores were all lower than those in the control group(P<0.05).Conclusion Chronic illness trajectory model-based intervention can improve pulmonary function,blood gas indexes,self-management skills and quality of life in COPD patients.Therefore,it is worthy of clinical promotion.