基于自我效能理论的慢性阻塞性肺疾病病人自我管理干预效果评价
Effect of self-management intervention based on self-efficacy theory in patient with chronic obstructive pulmonary disease
-
摘要: 目的：探讨基于自我效能理论的慢性阻塞性肺疾病（COPD）病人自我管理干预的效果，为优化COPD病人医疗服务提供循证依据。方法：选取稳定期COPD病人128例，按照随机数字表法分为观察组和对照组，各64例。对照组接受常规护理，观察组在常规护理基础上运用自我效能理论进行自我管理干预。于干预前和干预8周后分别采用6 min步行距离（6MWD）、呼吸困难严重程度分级标准评分（MRC）评价2组病人心肺功能、呼吸困难程度，同时采用健康知识问卷、自我效能量表和圣乔治呼吸问卷（SGRQ）评价病人健康知识水平、自我效能和生活质量改善情况。结果：干预前2组病人6MWD、MRC评分和健康知识问卷、自我效能量表、SGRQ评分差异均无统计学意义（P>0.05）。干预后2组病人6MWD、健康知识水平、自我效能各维度及总分均升高，MRC评分和SGRQ各维度评分均降低，且观察组6MWD、健康知识水平、自我效能各维度及总分升高幅度均明显大于对照组（P<0.01），MRC评分和SGRQ各维度评分降低幅度亦均明显大于对照组（P<0.01）。结论：运用自我效能理论进行自我管理干预，可有效促进病人临床康复，有助于增加对疾病的认知，并能提高自我护理能力，改善生活质量，值得临床推广。Abstract: Objective:To investigate the effects of self-management intervention based on self-efficacy theory in patient with chronic obstructive pulmonary disease(COPD),and provide the evidence in optimizing medical service.Methods:One hundred and twenty-eight patients with stabilization period COPD were randomly divided into the observation group and control group(64 cases each group).The control group were nursed with routine method,and the observation group was nursed with self-management intervention based on self-efficacy theory.The heart and lung function in two groups were evaluated using the 6 min walk distance(6MWD) and medical research council scale(MRC),and the health knowledge,self-efficacy and quality of life improvement in two groups were evaluated using health knowledge questionnaire,self-efficacy scale and St.George's respiratory questionnaire(SGRQ) before and after 8 weeks of intervention.Results:Before intervention,the differences of the scores of 6MWD,MRC,health knowledge questionnaire,self-efficacy scale and SGRQ between two groups were not statistically significant(P>0.05).After intervention,the scores of 6MWD,health knowledge,self-efficacy and total score in two groups increased,and the scores of MRC and SGRQ decreased.The increasing degrees of the 6MWD,health knowledge,self-efficacy and total score in observation group were significantly more than those in control group(P<0.01),and the decreasing degrees of the MRC and SGRQ in observation group were significantly more than those in control group(P<0.01).Conclusions:Self-management intervention based on self-efficacy theory can effectively promote the recovery of patient with COPD,increase the awareness of the disease,improve self-management skill and quality of life,which is worthy of promotion.
-
[1] 崔娟,殷鹏,王黎君,等.1990年与2013年中国大气臭氧污染导致慢性阻塞性肺疾病的疾病负担分析[J].中华预防医学杂志,2016,50(5):391. [2] 胡蕴绮,潘菁,万霞.社区老年人自我护理能力与自我效能感的相关性[J].中国老年学杂志,2015,35(5):1372. [3] 李娜,汪凤兰.老年病病人自我管理行为的干预[J].中国老年学杂志,2014,34(19):5587. [4] 陆再英.内科学[M].7版.北京:人民卫生出版社,2008. [5] EVALD T,KEITTELMANN S,SINDRUP JH,et al.The effect of inhaled terbutaline on FEV1,FVC,dyspnoea and walking distance in patients with chronic obstructive lung disease[J].Respir Med,1992,86(2):93. [6] PEREZ T,BURGEL PR,PAILLASSEUR JL,et al.Modified Medical Research Council scale vs Baseline Dyspnea Index to evaluate dyspnea in chronic obstructive pulmonary disease[J].Int J Chron Obstruct Pulmon Dis,2015,10(1):1663. [7] JONES PW,QUIRK FH,BAVEYSTOCK CM.The St George's Respiratory Questionnaire[J].Respir Med,1991,85(Suppl 2):25. [8] PISI R,AIELLO M,ZANINI A,et al.Small airway dysfunction and flow and volume bronchodilator responsiveness in patients with chronic obstructive pulmonary disease[J].Int J Chron Obstruct Pulmon Dis,2015,10(1):1191. [9] 赵振钧.慢性阻塞性肺疾病发生相关因素的研究进展[J].上海交通大学学报(医学版),2016,36(1):128. [10] YOUNG HM,APPS LD,HARRISON SL,et al.Important,misunderstood,and challenging:a qualitative study of nurses' and allied health professionals' perceptions of implementing self-management for patients with COPD[J].Int J Chron Obstruct Pulmon Dis,2015,10(1):1043. [11] 林允照,冯晨,刘敏.基于行为转变理论指导的阶段性干预对2型糖尿病病人自我效能及生存质量的影响[J].中国全科医学,2014,17(35):4157. [12] MOHAMMADI F,JOWKAR Z,REZA KHANKEH H,et al.Effect of home-based nursing pulmonary rehabilitation on patients with chronic obstructive pulmonary disease:a randomised clinical trial[J].Br J Community Nurs,2013,18(8):398. [13] WANG Y,ZANG XY,BAI J,et al.Effect of a Health Belief Model based nursing intervention on Chinese patients with moderate to severe chronic obstructive pulmonary disease:a randomized controlled trial[J].J Clin Nurs,2014,23(9/10):1342. [14] 陈琴,姜小鹰,房晓华.慢性阻塞性肺疾病病人自我照顾认知与自我效能的相关性研究[J].中华护理杂志,2015,50(2):234. [15] 胡世玲,熊昊,郭燕妮,等.圣乔治呼吸问卷在COPD病人疗效评价中的应用[J].西南国防医药,2012,22(2):231. [16] 赵云峰,姜艳平.圣乔治呼吸问卷和慢性阻塞性肺疾病评估测试问卷评价慢性阻塞性肺疾病稳定期病人健康相关生活质量的比较[J].上海医学,2013,36(1):47. -
点击查看大图
计量
- 文章访问数: 4184
- HTML全文浏览量: 516
- PDF下载量: 74
- 被引次数: 0
下载:
