基于因果分析的护理干预对慢阻肺患者遵医行为、病情恢复及生存质量的影响

Impact of nursing interventions based on causal analysis on compliance behaviors,recovery,and quality of life in patients with chronic obstructive pulmonary disease

目的探究基于因果分析的护理干预对慢性阻塞性肺疾病(简称慢阻肺)患者遵医行为、病情恢复及生存质量的影响。方法本研究为随机对照试验。前瞻性选取2022年1月至2022年12月陕西省核工业二一五医院收治的82例慢阻肺患者作为研究对象。采用随机数字表法,将患者分为对照组(41例)与研究组(41例)。对照组男23例,女18例;年龄(51.38±6.15)岁;病程(5.25±1.07)年。研究组男26例,女15例;年龄(50.74±6.61)岁;病程(5.51±1.24)年。对照组采用常规护理干预,研究组采用基于因果分析的护理干预。两组均干预1个月。比较两组患者遵医行为依从性,干预前后肺功能[呼气峰值流速(PEF)、第1秒用力呼气量(FEV1)、第1秒用力呼气容积和用力肺活量比值(FEV1/FVC)]、自我护理能力[自我护理能力测定量表(ESCA)]和生存质量[世界卫生组织生存质量简表(WHOQOL-BREF)]。采用独立样本t检验、配对t检验和χ^(2)检验。结果研究组遵医行为总依从率高于对照组[95.12%(39/41)比80.49%(33/41)](P<0.05)。干预后,研究组PEF、FEV1、FEV1/FVC均高于对照组[(5.34±1.03)L/s比(4.71±0.89)L/s、(1.95±0.44)L比(1.62±0.41)L、(75.42±7.86)%比(62.93±7.11)%](均P<0.05);研究组ESCA各维度(自我概念、自护责任感、自我护理技能、健康知识水平)评分均高于对照组[(30.03±1.15)分比(26.94±2.28)分、(22.09±1.12)分比(18.43±2.03)分、(40.20±2.58)分比(35.37±3.15)分、(46.98±2.12)分比(41.16±3.14)分](均P<0.05);研究组WHOQOL-BREF各维度(社会、环境、心理、生理)评分均高于对照组[(71.74±15.15)分比(64.59±13.79)分、(70.88±14.37)分比(64.12±13.85)分、(71.18±16.51)分比(63.71±14.96)分、(68.58±14.03)分比(62.03±12.72)分](均P<0.05)。结论基于因果分析的护理干预可改善慢阻肺患者遵医行为依从性,促进病情恢复,提高生存质量。

Objective To explore the impact of nursing interventions based on causal analysis on compliance behaviors,recovery,and quality of life in patients with chronic obstructive pulmonary disease(COPD).Methods This study was a randomized controlled trial.A total of 82 COPD patients admitted to No.215 Hospital of Shaanxi Nuclear Industry from January 2022 to December 2022 were prospectively selected as the study objects.The patients were divided into a control group(41 cases)and a study group(41 cases)by the random number table method.There were 23 males and 18 females in the control group,aged(51.38±6.15)years,and the course of disease was(5.25±1.07)years.There were 26 males and 15 females in the study group,aged(50.74±6.61)years,and the course of disease was(5.51±1.24)years.The control group received routine nursing care,and the study group received nursing interventions based on causal analysis for 1 month.The compliance behaviors and lung function[peak expiratory flow(PEF),forced expiratory volume in the first second(FEV1),ratio of forced expiratory volume in the first second to forced vital capacity(FEV1/FVC)],self-care ability(ESCA),and quality of life[WHO Quality of Life Brief Scale(WHOQOL-BREF)]before and after intervention were compared between the two groups.Independent sample t test,paired t test,andχ^(2) test were used.Results The total compliance rate of the study group was higher than that of the control group[95.12%(39/41)vs.80.49%(33/41)](P<0.05).After intervention,the PEF,FEV1,and FEV1/FVC in the study group were higher than those in the control group[(5.34±1.03)L/s vs.(4.71±0.89)L/s,(1.95±0.44)L vs.(1.62±0.41)L,(75.42±7.86)%vs.(62.93±7.11)%](all P<0.05).The scores of self-concept,self-care responsibility,self-care skills,and health knowledge level of the ESCA in the study group were higher than those in the control group[(30.03±1.15)points vs.(26.94±2.28)points,(22.09±1.12)points vs.(18.43±2.03)points,(40.20±2.58)points vs.(35.37±3.15)points,(46.98±2.12)points vs.(41.16±3.14)points](all P<0.05).The scores of social,environmental,psychological,and physiological dimensions of the WHOQOL-BREF of the study group were higher than those of the control group[(71.74±15.15)points vs.(64.59±13.79)points,(70.88±14.37)points vs.(64.12±13.85)points,(71.18±16.51)points vs.(63.71±14.96)points,(68.58±14.03)points vs.(62.03±12.72)points](all P<0.05).Conclusion Nursing interventions based on causal analysis can improve the compliance behaviors in COPD patients,promote the disease recovery,and improve their quality of life.