基于NOC系统的多维度护理模式对AECOPD患者病情控制、心理应激及运动耐量的影响

Effects of Multi-dimensional Nursing Mode Based on NOC System on Disease Control,Psychological Stress and Exercise Tolerance in AECOPD Patients

目的:分析基于护理结局分类(NOC)系统的多维度护理模式对慢性阻塞性肺疾病急性加重期(AECOPD)患者病情控制、心理应激及运动耐量的影响。方法:选择上饶市中医院于2020年1月—2023年1月收治的AECOPD患者80例,根据入院后不同时期护理方式的不同将所有纳入患者分成对照组(n=40)和观察组(n=40)。对照组给予常规护理,观察组在其基础上开展基于NOC系统的多维度护理,共护理2周。对比两组护理前后的肺功能[第1秒用力呼气容积(FEV_(1))、用力肺活量(FVC)、第1秒用力呼气容积占用力肺活量的百分比(FEV_(1)/FVC%)、最大呼气中期流量(MMEF)、最大自主通气量(MVV)]、血气指标[动脉氢离子浓度(pH)、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))、动脉血氧饱和度(SaO_(2))]、呼吸功能[慢性阻塞性肺疾病评估测试(CAT评分)、改良版英国医学研究学会呼吸困难量表(mMRC)]、生活质量[圣乔治呼吸问卷(SGRQ)]、心理应激状况[焦虑自评量表(SAS)、抑郁自评量表(SDS)]、运动耐量。结果:护理2周后,观察组FVC、FEV_(1)、FEV_(1)/FVC%、MMEF、MVV均高于对照组,差异均有统计学意义(P<0.05);护理2周后,观察组pH、PaO_(2)、SaO_(2)均高于对照组,PaCO_(2)低于对照组,差异均有统计学意义(P<0.05);护理2周后,观察组CAT、mMRC、SGRQ均低于对照组,差异均有统计学意义(P<0.05);护理2周后,观察组SAS、SDS均低于对照组,差异均有统计学意义(P<0.05);观察组运动耐量距离长于对照组,差异有统计学意义(P<0.05)。结论:基于NOC系统的多维度护理模式能帮助AECOPD患者增强肺通气功能,改善血气指标,增强呼吸功能,改善患者不良心理状态,提高运动耐量。

Objective:To analyze the effects of multi-dimensional nursing mode based on nursing outcome classification(NOC)system on disease control,psychological stress and exercise tolerance in patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Method:A total of 80 patients with AECOPD admitted to Shangrao Hospital of Traditional Chinese Medicine were enrolled from January 2020 to January 2023,they were divided into control group(n=40)and observation group(n=40)by the different nursing methods in different periods after admission.The control group was given routine nursing,while observation group was additionally given multi-dimensional nursing based on NOC system,all were intervened for 2 weeks.The pulmonary function[forced expiratory volume in 1 second(FEV_(1)),forced vital capacity(FVC),FEV_(1) as a percentage of FVC(FEV_(1)/FVC%),maximum mid-expiratory flow(MMEF),maximal voluntary ventilation(MVV)],blood gas indexes[arterial hydrogen ion concentration(pH),arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2)),arterial oxygen saturation(SaO_(2))],respiratory function[COPD assessment test(CAT),modified Medical Research Council(mMRC)],quality of life[St.George's respiratory questionnaire(SGRQ)],psychological stress[self-rating anxiety scale(SAS),self-rating depression scale(SDS)]and exercise tolerance were compared between the two groups before and after nursing.Result:After 2 weeks of nursing,FVC,FEV_(1),FEV_(1)/FVC%,MMEF and MVV in observation group were higher than those in control group,the differences were statistically significant(P<0.05);after 2 weeks of nursing,pH,PaO_(2) and SaO_(2) in observation group were higher than those in control group,while PaCO_(2) was lower than that in control group,the differences were statistically significant(P<0.05);after Medical Innovation of China Vol.21,No.9 March,20242 weeks of nursing,the scores of CAT,mMRC and SGRQ in observation group were lower than those in control group,the differences were statistically significant(P<0.05);after 2 weeks of nursing,the scores of SAS and SDS in observation group were lower than those in control group,the differences were statistically significant(P<0.05),and exercise tolerance distance in observation group was farther than that in control group,the difference was statistically significant(P<0.05).Conclusion:Multi-dimensional nursing mode based on NOC system is beneficial to improve pulmonary ventilation function,blood gas indexes,respiratory function,adverse psychological state and exercise tolerance in AECOPD patients.