中年慢性阻塞性肺疾病患者主动运动康复行为与症状变化轨迹的关系研究

doi:10.3761/j.issn.0254-1769.2025.16.011

摘要/Abstract

摘要：

目的探究中年慢性阻塞性肺疾病患者主动运动康复行为与相关症状的时变特征及关联度，为构建全周期精准康复管理体系提供依据。方法运用生态瞬时评估法，通过便利抽样法于2024年10月15日—12月1日选取武汉市某三级甲等综合医院呼吸与危重症医学科收治的63例中年慢性阻塞性肺疾病患者为调查对象，应用基线调查表、每日主动运动康复行为评估问卷、每日症状评估问卷对其主动运动康复行为（运动项目数、持续时长）及相关症状（呼吸困难、疲乏、焦虑）进行为期1周的持续动态监测，采用多层线性模型分析主动运动康复行为与症状间的动态关联。结果最终纳入58例患者。在为期1周的生态瞬时评估期间，系统共触发1 218次评估提示，获得有效响应1 120次，有效响应率为91.95%，患者日均完成（2.76±0.39）次评估。多层线性模型显示，瞬时呼吸困难、疲乏、焦虑症状及基线时的运动恐惧均可负向影响中年慢性阻塞性肺疾病患者主动运动康复行为（P<0.05）。结论中年慢性阻塞性肺疾病患者的主动运动康复行为与相关症状存在动态变化，护理人员应构建基于症状波动的精准康复干预方案，以实现肺康复效果的长期优化。

关键词: 中年, 慢性阻塞性肺疾病, 主动运动康复行为, 症状, 生态瞬时评估, 康复护理

Abstract:

Objective To explore the temporal characteristics and correlation between active exercise rehabilitation behaviour and related symptoms in middle-aged chronic obstructive pulmonary disease（COPD） patients，and to provide a basis for constructing a full cycle precision rehabilitation management system. Methods The ecological momentary assessment method was used to select 63 middle-aged COPD patients from the respiratory and critical care medicine department of a tertiary comprehensive hospital in Wuhan from October 15 to December 1，2024，using convenience sampling. Their active exercise rehabilitation behaviour（number of exercise projects，duration） and related symptoms（dyspnea，fatigue，anxiety） were continuously monitored for a week by using baseline survey，daily active exercise rehabilitation behavior assessment questionnaire，daily symptom assessment questionnaire. A multi-layer linear model was used to analyze the dynamic correlation between active exercise rehabilitation behaviour and symptoms. Results 58 patients were included. During the 1-week ecological momentary assessment，the system triggered a total of 1，218 momentary assessments and obtained 1，120 valid responses（with the valid response rate of 91.95%），with patients completing an average of（2.76±0.39） assessments per day. Multilevel linear models showed that momentary dyspnoea，fatigue，anxiety symptoms and baseline kinesiophobia all significantly negatively influenced active exercise rehabilitation behaviour（P<0.05）. Conclusion There are dynamic changes in the active exercise rehabilitation behaviour and related symptoms of middle-aged COPD patients. Nursing staff should establish a precise rehabilitation intervention system based on symptom fluctuations，strengthen patient self-management efficiency through dynamic monitoring and hierarchical management，and achieve long-term optimization of lung rehabilitation effects.

Key words: Middle-Aged, Pulmonary Disease，Chronic Obstructive, Active Exercise Rehabilitation Behaviour, Symptom, Ecological Momentary Assessment, Rehabilitation Nursing

程蓉, 张志霞, 刘莉敏, 陈秋霞, 杨振, 吴慧, 姜芳, 乔林茹. 中年慢性阻塞性肺疾病患者主动运动康复行为与症状变化轨迹的关系研究[J]. 中华护理杂志, 2025, 60(16): 1996-2001.

CHENG Rong, ZHANG Zhixia, LIU Limin, CHEN Qiuxia, YANG Zhen, WU Hui, JIANG Fang, QIAO Linru. Relationship between active exercise rehabilitation behavior and symptoms trajectory in middle aged patients with chronic obstructive pulmonary disease[J]. Chinese Journal of Nursing, 2025, 60(16): 1996-2001.

图/表 2

表1 中年慢阻肺患者住院期间主动运动康复行为及相关症状评分情况（n=58，$\bar{x}\pm s$）

Table 1 Active exercise rehabilitation behaviour and symptom scores in middle-aged COPD patients during hospitalisation（n=58，$\bar{x}\pm s$）

表2 中年慢阻肺患者相关症状及运动恐惧对其主动康复行为的预测结果

Table 2 The predictive results of symptoms and exercise fear in middle-aged patients with COPD on their active rehabilitation behavior

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