健康行为改变整合理论的康复护理模式对慢性阻塞性肺疾病患者肺功能及自我管理能力的影响研究

Effect of Health Behavior Change Integrated Rehabilitation Nursing Model on Pulmonary Function and Self-management Ability in Patients with Chronic Obstructive Pulmonary Disease

目的:探究健康行为改变整合(ITHBC)理论的康复护理模式对慢性阻塞性肺疾病(COPD)患者肺功能及自我管理能力的影响。方法:选取2019年5月—2022年12月河南省第二人民医院收治的98例COPD患者作为研究对象,依据随机数表法分为对照组和观察组,每组各49例。对照组患者给予常规护理干预,观察组患者在对照组基础上给予ITHBC理论的康复护理模式。比较两组患者干预前后肺功能[每分钟最大通气量(MVV)、用力肺活量(FVC)、第1秒用力呼气容积与最大呼气容量比率(FEV_(1)/FVC)、一氧化碳弥散量值(DLCO)]、6 min步行距离(6 MWD)、自我管理能力、自我效能(GSES)、自我负担(SPBS)、希望水平(HHI)、生活质量(SGRQ)情况。结果:干预后,观察组患者MVV、FVC、FEV_(1)/FVC、DLCO、6 MWD均高于对照组患者,差异均有统计学意义(t=10.040、2.420、5.648、5.496、3.707,P<0.05)。干预后,观察组患者自我管理能力、GSES、HHI评分均高于对照组患者,观察组患者SPBS评分低于对照组患者,差异均有统计学意义(t=6.050、4.281、4.620、4.293,P<0.05)。干预后,观察组患者疾病影响、活动受限、呼吸症状评分均低于对照组患者,差异均有统计学意义(t=3.701、7.118、4.647,P<0.05)。结论:ITHBC理论的康复护理模式应用于COPD患者中,可提升患者自我管理能力及心理健康水平,有助于促进其肺功能恢复,从而提高其生活质量。

Objective:To explore the effect of Integrated Health Behavior Change(ITHBC)theory in the patients with chronic obstructive pulmonary disease(COPD).Methods:98 patients with COPD treated in the hospital from May 2019 to December 2022 were selected as the study objects,and they were divided into 2 groups according to random number table method.49 patients in the control group were given routine nursing intervention,and 49 patients in the observation group were given ITHBC theory rehabilitation nursing mode on the basis of the control group.Pulmonary function(MVV,FVC,DLCO,FEV_(1)/FVC),exercise endurance(6 MWD),self-management ability,self-efficacy(GSES),self-burden(SPBS),hope level(HHI)and quality of life(SGRQ)were compared between the two groups before and after intervention.Results:After intervention,MVV,FVC,FEV_(1)/FVC,DLCO and 6 MWD in observation group were higher than those in control group(t=10.040,2.420,5.648,5.496,3.707;P<0.05).After the intervention,the self-management ability,GSES and HHI scores of patients in the observation group were higher than those in the control group,and the SPBS scores of patients in the observation group were lower than those in the control group,with statistically significant difference(t=6.050,4.281,4.620,4.293;P<0.05).After the intervention,the disease impact,activity restriction and respiratory symptom scores in the observation group were lower than those in the control group,with statistically significant difference(t=3.701,7.118,4.647;P<0.05).Conclusion:ITHBC theory of rehabilitation nursing mode in COPD patients can improve the self-management ability and mental health level of patients,and help to promote the recovery of lung function and improve the quality of life.