Abstract:

Objective To construct and preliminarily apply a graded exercise rehabilitation program for patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD），and to provide a theoretical basis for the scientific implementation of exercise rehabilitation by medical staff. Methods Based on Triangle model and evidence-based method，the first draft of the graded exercise rehabilitation program was constructed，and the items were revised through 2 rounds of expert consultations from March to October，2023. The graded exercise rehabilitation program was preliminarily applied in 10 patients with AECOPD. Results The effective recovery rates of the 2 rounds of expert consultation questionnaires were 100%；the expert authority coefficients were 0.857 and 0.863；the coefficients of variation were 0-0.285 and 0.052-0.244；the Kendall’s harmony coefficients were 0.167 and 0.145，respectively（all P<0.001）. The final plan includes 4 first-level indicators，13 second-level indicators，and 25 third-level indicators. The scores of 6 min walking test，mMRC and CAT after exercise were improved compared with those before exercise，and the differences were statistically significant（all P<0.05）. Conclusion The graded exercise rehabilitation program for patients with AECOPD constructed in this study has good scientificity and practicability，which can provide references for clinical implementation of exercise rehabilitation.

Key words: Pulmonary Disease, Chronic Obstructive, Acute Exacerbation, Exercise Rehabilitation, Triangle Model, Delphi Method, Nursing Care

摘要：

目的 构建COPD急性加重期患者肺康复分级方案并进行初步应用，为护理人员科学地实施肺康复提供参考。 方法 2023年3月—10月，基于Triangle模型和循证方法构建肺康复分级方案初稿，通过2轮专家函询对条目进行修订，将构建的肺康复分级方案在10例COPD急性加重期患者中进行初步应用。 结果 2轮专家函询问卷有效回收率均为100%，专家权威系数分别为0.857、0.863，变异系数分别为0~0.285、0.052~0.244，肯德尔和谐系数分别为0.167、0.145（均P<0.001）。最终形成的方案包括4个一级指标，13个二级指标，25个三级指标。方案应用后患者6 min步行试验、改良版英国医学研究委员会呼吸困难问卷和COPD疾病评分较干预前均有所改善，差异具有统计学意义（均P<0.05）。 结论 该研究构建的COPD急性加重期患者肺康复分级方案具有较好的科学性和实用性，可为临床实施肺康复提供参考。

关键词: 肺疾病, 慢性阻塞性, 急性加重期, 运动康复, Triangle模型, 德尔菲法, 护理