慢性阻塞性肺疾病患者疾病感知干预方案的构建与应用

doi:10.3761/j.issn.0254-1769.2024.11.001

摘要/Abstract

摘要：

目的构建基于自我调节常识模型的COPD患者疾病感知干预方案并初步探讨其应用效果。方法在系统检索文献的基础上，通过内容分析形成COPD患者疾病感知干预方案初稿。2022年5月—8月，经过2轮专家函询，形成COPD患者疾病感知干预方案。采用便利抽样法，于2022年12月—2023年1月，选取在江苏省某2所医院呼吸内科住院的COPD患者作为研究对象。试验组采用COPD患者疾病感知干预方案进行护理，对照组采用常规护理，干预前、干预后、干预后1个月使用简易疾病感知问卷、改良版英国医学研究委员会呼吸困难问卷、简易疾病感知问卷、接纳与行动问卷第2版、慢性阻塞性肺疾病患者自我评估测试问卷、慢性阻塞性肺疾病患者自我护理量表比较两组间的差异。结果形成的COPD患者疾病感知干预方案包括6个干预主题，24条干预条目。2轮函询中专家权威系数为0.81，第2轮条目重要性和可行性的肯德尔协调系数为0.19和0.16（均P<0.001）。在方案应用阶段，患者的招募率为56%，退出率为15%，高依从率为80%。重复测量方差分析显示，两组接纳与行动得分比较时间与组间存在交互效应（P<0.05），两组的简易疾病感知问卷得分、COPD患者自我评估测试问卷得分、COPD患者自我护理量表得分在时间效应上差异具有统计学意义（P<0.05），两组的简易疾病感知问卷得分、接纳与行动问卷第2版得分组间主效应上差异具有统计学意义（P<0.05）。结论构建的COPD患者疾病感知干预方案具有一定的科学性、可行性和有效性，可为临床医护人员促进COPD患者疾病感知和改善负性心理提供参考。

关键词: 慢性阻塞性肺疾病, 疾病感知, 自我调节常识模型, 德尔菲技术, 护理

Abstract:

Objective To establish an illness perception intervention program for patients with chronic obstructive pulmonary disease（COPD） and preliminarily analyse its application effect. Methods On the basis of systematic retrieval，a draft of the illness perception intervention program for patients with COPD was formed through content analysis. From May to August 2022，after 2 rounds of expert consultation，the illness perception intervention program for patients with COPD was formed. Patients with COPD who were hospitalized in the respiratory departments of 2 hospitals in Jiangsu Province from December 2022 to January 2023 were selected as the study subjects by convenience sampling method. The experimental group was treated with the illness perception intervention program，while the control group was treated with routine nursing. The effects of the 2 groups were compared by Brief Illness Perception Questionnaire，Modified British Medical Research Council、Brief Illness Perception Questionnaire、Acceptance and Action Questionnaire Ⅱ，COPD Assessment Test，COPD Self-management Scale before and after intervention，and a month after intervention. Results The illness perception intervention program for patients with COPD included 6 intervention topics and 24 specific intervention items. In the 2 rounds of correspondence，the expert group authority coefficient was 0.81，and the Kendall coordination coefficients were 0.19 and 0.16 in the second round（all P<0.001）. In the intervention study，the recruitment rate of patients was 56%；the withdrawal rate was 15%；and the high compliance rate was 80%. Repeated measures analysis of variance showed that there was an interaction effect between the scores of Acceptance and Action Questionnaire Ⅱ of the 2 groups（P<0.05）. The differences in the scores of Brief Illness Perception Questionnaire，COPD Assessment Test，Self-management Scale between the 2 groups were statistically significant in terms of time effect（P<0.05），and the differences in the scores of the Brief Illness Perception Questionnaire and Acceptance and Action Questionnaire Ⅱ between the 2 groups were statistically significant in terms of main effect（P<0.05）. Conclusion The established illness perception intervention program for patients with COPD is scientific，feasible and effective，and it can provide practical references for clinical healthcare workers to promote illness perception and improve negative psychology in patients with COPD.

Key words: Chronic Obstructive Pulmonary Disease, Illness Perception, Common-Sense Model of Self-Regulation, Delphi Technique, Nursing Care

王晨, 汤婷, 孙晓慧, 屈明叶, 陈元元, 刘扣英. 慢性阻塞性肺疾病患者疾病感知干预方案的构建与应用[J]. 中华护理杂志, 2024, 59(11): 1285-1293.

WANG Chen, TANG Ting, SUN Xiaohui, QU Mingye, CHEN Yuanyuan, LIU Kouying. Construction and preliminary application of an illness perception intervention program for patients with chronic obstructive pulmonary disease[J]. Chinese Journal of Nursing, 2024, 59(11): 1285-1293.

图/表 3

表1 慢性阻塞性肺疾病患者疾病感知干预方案

Table 1 The illness perception intervention program for patients with COPD

表2 两组一般资料的比较（例）

Table 2 Comparison of general information between the two groups（case）

表3 两组干预前、干预后、干预后1个月有效性评价指标的比较

Table 3 Comparison of efficacy evaluation indicators before and after intervention，and a month after intervention between the 2 groups

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