中重度慢性阻塞性肺疾病患者肺康复方案的实施效果研究

doi:10.3761/j.issn.0254-1769.2024.17.002

摘要/Abstract

摘要：

目的探讨基于信息-动机-行为技巧模型的肺康复方案在中重度慢性阻塞性肺疾病患者中的应用效果。方法采用便利抽样法，于2021年10月—2022年2月，选取烟台市某三级甲等医院呼吸与危重症医学科收治的中重度慢性阻塞性肺疾病患者为研究对象，随机分为试验组（n=32）和对照组（n=31）。试验组在常规护理的基础上实施6个月的基于信息-动机-行为技巧模型的肺康复，对照组实施常规护理措施，比较干预前及干预后两组呼吸困难程度、运动耐力、生活质量、肺康复依从性、自我管理水平及肺功能情况。结果干预后，试验组呼吸困难程度、运动耐力、生活质量、肺康复依从性及自我管理水平均优于对照组，差异有统计学意义（P<0.05），但两组肺功能的比较，差异无统计学意义（P>0.05）。结论基于信息-动机-行为技巧模型的肺康复可有效缓解中重度慢性阻塞性肺疾病患者呼吸困难症状，提高其运动耐力、肺康复的依从性及自我管理能力，改善生活质量。

关键词: 信息-动机-行为技巧模型, 肺疾病, 慢性阻塞性, 肺康复, 自我管理, 护理

Abstract:

Objective To explore the application and effect of a pulmonary rehabilitation exercise program in patients with moderate to severe COPD based on the Information-Motivation-Behavior Skill（IMB） Model. Methods The convenience sampling method was adopted to select patients with moderate to severe COPD admitted to the department of respiratory and critical care medicine in a tertiary A hospital in Yantai City from October 2021 to February 2022. They were randomly divided into an intervention group（32 cases） and a control group（31 cases）. The intervention group was treated with the pulmonary rehabilitation exercise program based on the IMB model on the basis of routine nursing，while the control group was treated with routine nursing. The degree of dyspnea，exercise endurance，quality of life，pulmonary rehabilitation exercise compliance，self-management ability and lung function were compared between the 2 groups before and 6 months after the intervention. Results After intervention，the degree of dyspnea，exercise endurance，quality of life，pulmonary rehabilitation exercise compliance and self-management ability were significantly different between the 2 groups（P<0.05）. There was no statistically significant difference in lung function between the 2 groups after intervention（P>0.05）. Conclusion The pulmonary rehabilitation program based on IMB model can effectively alleviate the symptoms of dyspnea in patients with moderate to severe COPD，improve exercise endurance，improve pulmonary rehabilitation exercise compliance and self-management ability，and improve the patients’ quality of life.

Key words: Information-Motivation-Behavior Skill Model, Pulmonary Disease, Chronic Obstructive, Pulmonary Rehabilitation, Self-Management, Nursing Care

赵凌燕, 王正翊, 徐淑芬, 杜田田. 中重度慢性阻塞性肺疾病患者肺康复方案的实施效果研究[J]. 中华护理杂志, 2024, 59(17): 2062-2069.

ZHAO Lingyan, WANG Zhengyi, XU Shufen, DU Tiantian. Application of a pulmonary rehabilitation exercise program based on IMB model in patients with moderate to severe chronic obstructive pulmonary disease[J]. Chinese Journal of Nursing, 2024, 59(17): 2062-2069.

图/表 7

表1 中重度慢阻肺患者肺康复干预方案

Table 1 Pulmonary rehabilitation exercise plan for COPD patients

表2 两组一般资料的比较

Table 2 Comparison of general data between the 2 groups

表3 两组干预前后呼吸困难程度、生活质量的比较（分，$\bar{x}\pm s$）

Table 3 Comparison of dyspnea and quality of life between 2 groups before and after intervention（scores，$\bar{x}\pm s$）

表4 两组干预前后6 min步行试验的比较（m，$\bar{x}\pm s$）

Table 4 Comparison of 6MWT between 2 groups before and after intervention（m，$\bar{x}\pm s$）

表5 两组干预前自我管理水平的比较（分，$\bar{x}\pm s$）

Table 5 Comparison of self-management levels between 2 groups before intervention（scores，$\bar{x}\pm s$）

表6 两组干预后自我管理水平比较（分，$\bar{x}\pm s$）

Table 6 Comparison of self-management levels between 2 groups after intervention（scores，$\bar{x}\pm s$）

表7 两组干预前后肺功能指标的比较（$\bar{x}\pm s$）

Table 7 Comparison of lung function indicators between 2 groups before and after intervention（$\bar{x}\pm s$）

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