微信结合Orem理论模式下的系统护理在COPD患者延续性护理中的应用

Application of systematic nursing based on both WeChat and Orem’s Self-care Theory in the continuity of care for patients with chronic obstructive pulmonary disease

目的 探讨微信结合Orem理论模式下的系统护理在慢性阻塞性肺疾病(COPD)患者延续性护理中的应用效果。方法 选取河南大学第一附属医院呼吸与危重症医学科2022年1月至2023年12月经治疗出院的96例COPD患者纳入研究,按随机数表法分为对照组和研究组,每组48例。对照组患者给予常规延续性护理,研究组患者在此基础上给予微信结合Orem理论模式下的系统护理,两组均延续护理3个月。比较两组患者的治疗依从性,出院当天、出院后1个月和3个月的睡眠质量[匹兹堡睡眠质量指数量表(PSQI)]、自我管理量表评分、临床症状[COPD患者报告结局量表修订版(m COPD-PRO)]、运动能力[6 min步行试验(6MWT)]、血氧饱和度(SpO2)及生活质量[COPD评估测试(CAT)]。结果 研究组患者的治疗依从性为100.00%,明显高于对照组的83.33%,差异有统计学意义(P<0.05);出院后1个月、3个月,研究组患者的PSQI评分分别为(8.34±1.46)分、(6.35±1.30)分,明显低于对照组的(10.45±1.68)分、(8.26±1.46)分,差异均有统计学意义(P<0.05);出院后1个月、3个月,研究组患者的自我管理能力评分分别为(176.84±11.32)分、(188.36±10.06)分,明显高于对照组的(168.64±10.48)分、(176.45±9.82)分,差异均有统计学意义(P<0.05);出院后1个月、3个月,研究组患者的mCOPD-PRO评分分别为(36.55±4.02)分、(29.84±3.26)分,明显低于对照组的(45.69±4.53)分、(36.56±3.52)分,差异均有统计学意义(P<0.05);出院后1个月、3个月,研究组患者的6MWT、SpO2分别为(353.85±30.65) m、(97.41±1.18)%和(426.98±35.49) m、(98.26±0.84)%,明显高于对照组的(300.49±26.98) m、(95.26±1.36)%和(375.74±33.85) m、(97.65±1.08)%,差异均有统计学意义(P<0.05);出院后1个月、3个月,研究组患者的CAT评分分别为(19.68±3.12)分、(14.69±2.68)分,明显低于对照组的(23.85±3.59)分、(19.46±3.85)分,差异均有统计学意义(P<0.05)。结论 微信结合Orem理论模式下的系统护理在COPD患者延续性护理中的应用能提高患者自我管理能力,增强治疗依从性,改善患者睡眠质量,减轻疾病症状,提高运动能力和血氧饱和度,并提升患者的生活质量。

Objective To explore the application effect of systematic nursing based on both WeChat and Orem's Self-care Theory in the continuity of care for patients with chronic obstructive pulmonary disease(COPD).Methods A total of 96 COPD patients discharged from the Department of Respiratory and Critical Care Medicine,the First Affiliated Hospital of Henan University between January 2022 and December 2023 were enrolled and randomly divided into a control group and a study group using a random number table,with 48 cases in each group.Patients in the control group received routine continuing nursing,while patients in the study group received systematic nursing based on both WeChat and Orem's Self-care Theory,all for 3 months.The treatment compliance,sleep quality(Pittsburgh Sleep Quality Index,PSQI),Self-management Scale score,clinical symptoms(the modified Patient-reported Outcome Scale for Chronic Obstructive Pulmonary Disease,mCOPD-PRO),exercise capacity(6-minute walk test,6MWT),blood oxygen saturation(SpO2),and quality of life(COPD Assessment Test,CAT)were compared between the two groups on the day of discharge,one month after discharge,and three months after discharge.Results The treatment compliance of patients in the study group was 100.00%,which was significantly higher than 83.33%of the control group(P<0.05).The PSQI scores of patients in the study group were (8.34±1.46) points and (6.35±1.30) points at 1 month and 3 months after dis-charge, respectively, which were significantly lower than (10.45±1.68) points and (8.26±1.46) points in the control group (P<0.05). At one month and three months after discharge, the self-management ability scores of patients in the study group were (176.84±11.32) points and (188.36±10.06) points, respectively, which were significantly higher than (168.64± 10.48) points and (176.45±9.82) points of the control group (P<0.05). The mCOPD-PRO scores of patients in the study group were (36.55±4.02) points and (29.84±3.26) points at one month and 3 months after discharge, respectively, which were significantly lower than (45.69±4.53) points and (36.56±3.52) points in the control group (P<0.05). The 6MWT and SpO2 of patients in the study group were (353.85±30.65) m and (97.41±1.18)% at one month after discharge and (426.98±35.49) m and (98.26±0.84)% at three months after discharge, respectively, which were significantly higher than (300.49±26.98) m and (95.26±1.36)% at one month and (375.74±33.85) m and (97.65±1.08)% at three months in the control group (P<0.05). At one month and three months after discharge, the CAT scores of patients in the study group were (19.68±3.12) points and (14.69±2.68) points, respectively, which were significantly lower than (23.85±3.59) points and (19.46±3.85) points in the control group (P<0.05). Conclusion The application of based on both WeChat and Orem ’s Self-care Theory in the continuity of care for patients with COPD can improve patients' self-management ability, en-hance treatment compliance, improve patients' sleep quality, alleviate disease symptoms, improve exercise capacity and blood oxygen saturation, and enhance patients' quality of life.