自我管理教育對(duì)無創(chuàng)通氣治療慢性阻塞性肺疾病患者自我管理能力及生活質(zhì)量的影響

鄒龍華 楊洋 尚龍華

[摘要]目的 探討自我管理教育對(duì)無創(chuàng)通氣治療慢性阻塞性肺疾病（COPD）患者自我管理能力及生活質(zhì)量的影響。方法 選取2016年3月～2018年1月洪都中醫(yī)院門診收治的90例無創(chuàng)通氣治療的COPD穩(wěn)定期患者作為研究對(duì)象，根據(jù)隨機(jī)數(shù)字表法分為兩組，每組各45例。對(duì)照組采用常規(guī)護(hù)理，觀察組在對(duì)照組基礎(chǔ)上聯(lián)合自我管理教育，3個(gè)月為一個(gè)療程。比較兩組干預(yù)前后的二氧化碳分壓（PaCO2）、生活質(zhì)量評(píng)分（SQLI）情況，比較兩組的自我效能評(píng)分及自我管理能力評(píng)分。結(jié)果 干預(yù)后觀察組的PaCO2低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；干預(yù)后觀察組的SQLI評(píng)分、自我效能評(píng)分及自我管理能力評(píng)分均高于對(duì)照組（P<0.05）。結(jié)論 對(duì)于COPD緩解期患者而言應(yīng)用自我管理教育有著重要意義，值得推廣。

[關(guān)鍵詞]慢性阻塞性肺疾?。蛔晕夜芾斫逃?；無創(chuàng)通氣治療；自我管理能力；自我效能；生活質(zhì)量

[中圖分類號(hào)] R473.5 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 1674-4721（2018）11（b）-0121-03

[Abstract] Objective To explore the influence of self-management education on self-management ability， self-efficacy and quality of life of non-invasive ventilation for COPD patients. Methods Ninety patients with noninvasive ventilation during the period of stable COPD treated in outpatient department of Hongdu Traditional Chinese Medical Hospital from March 2016 to January 2018 were selected as the study subjects， and divided into two groups according to the random number table method， with 45 cases in each group. In the control group， patients were treated with routine care， and patients in the observation group were treated with self-management education on basis of the control group. Three months were a course of treatment. The PaCO2 and quality of life scores （SQLI） were compared before and after intervention， and the self-efficacy scores and self-management ability scores of the two groups were compared. Results After the intervention， the PaCO2 in the observation group was lower than that in the control group （P<0.05）. After the intervention， the SQLI score， self-efficacy score and self-management ability score of the observation group were higher than those of the control group （P<0.05）. Conclusion The application of self-management education is important for patients with COPD in remission. It is worth promoting.

[Key words] COPD； Self-management education； Non-invasive ventilation； Self-management ability； Self-efficacy； Quality of life

慢性阻塞性肺疾?。–OPD）以持續(xù)氣流受限為特征，可見咳嗽咳痰、胸悶氣喘等表現(xiàn)，一旦發(fā)病病情可呈進(jìn)行性加重趨勢(shì)[1]。目前認(rèn)為緩解期是COPD治療的關(guān)鍵時(shí)期，及時(shí)規(guī)范治療可減少發(fā)作次數(shù)[2]。家用無創(chuàng)通氣是一種行之有效的治療手段，但受到醫(yī)學(xué)知識(shí)欠缺及目前護(hù)理方案過于簡(jiǎn)單的影響，導(dǎo)致不少患者應(yīng)用時(shí)療效較有限[3]。傳統(tǒng)護(hù)理模式注重于患者院內(nèi)情況，且忽視了患者對(duì)家庭醫(yī)療器械操作的培訓(xùn)管理。近年來自我管理教育在本病中的應(yīng)用價(jià)值逐漸得到重視，本研究旨在探討其在無創(chuàng)通氣COPD患者中的應(yīng)用價(jià)值，現(xiàn)報(bào)道如下。

1資料與方法

1.1一般資料

選取2016年3月～2018年1月洪都中醫(yī)院門診收治的90例無創(chuàng)通氣治療的COPD穩(wěn)定期患者作為研究對(duì)象，根據(jù)隨機(jī)數(shù)字表法分為兩組，每組各45例。……