家庭支持對COPD患者自我管理、生活質量及情緒管理的干預研究
發(fā)布時間：2018-11-03 20:24
【摘要】：目的通過對COPD患者的家庭支持系統(tǒng)進行干預,建立以家庭為中心的慢病管理模式,探討對COPD患者自我管理能力、生活質量及情緒的影響,以期為有效提高COPD患者自我管理能力,改善其生活質量和情緒,建立更合理的COPD慢病管理模式提供科學依據(jù)。方法便利選取青島大學附屬醫(yī)院100例住院COPD患者,按入院的先后順序分組,2013年11月至2015年1月收集對照組,對照組實施以患者為中心的慢病管理;2015年2月至2016年2月收集試驗組,試驗組對COPD患者的家庭支持系統(tǒng)進行干預,實施患者、患者配偶及其子女共同參與的以家庭為中心的慢病管理。對照組和實驗組各50例,兩組干預時間均為6個月。采用自我管理量表、圣喬治呼吸問卷(SGRQ)、6分鐘步行試驗(6MWT)及綜合性醫(yī)院焦慮抑郁量表(HAD)評價對患者的自我管理能力、生活質量及情緒的影響,采用家庭支持自評量表評估試驗組家庭支持干預效果。所有資料應用SPSS 17.0軟件包處理,計數(shù)資料采用c2檢驗,計量資料采用t檢驗。結果本次研究,對照組患者50例,平均年齡65.46±6.49歲,其中男性36例,女性14例。試驗組患者50例,平均年齡66.00±4.61歲,其中男性38例,女性12例。統(tǒng)計結果顯示:1.兩組患者在干預前的一般資料:性別、年齡、文化程度、家庭月收入、疾病嚴重程度、呼吸困難程度、自理能力、活動能力、自我管理能力等方面的差別無統(tǒng)計學意義(P0.05),具有可比性。2.患者自我管理能力:干預6個月后,試驗組癥狀管理得分(29.54±2.40)、日常生活管理得分(49.16±5.59)、情緒管理得分(45.52±3.91)、信息管理得分(20.28±2.72)、自我效能管理得分(32.38±3.21)、自我管理總分(176.88±11.36),與對照組癥狀管理得分(23.02±2.72)、日常生活管理得分(41.92±5.01)、情緒管理得分(37.34±4.87)、信息管理得分(15.88±3.09)、自我效能管理得分(24.84±3.84)、自我管理總分(143.0±12.99)相比,試驗組自我管理各項得分均高于對照組(P0.01)。3.患者生活質量:干預6個月后,試驗組圣喬治呼吸問卷總分(37.59±9.03)、呼吸癥狀得分(37.5±8.64)、活動受限得分(37.6±11.18)、疾病影響得分(37.5±10.81)、6分鐘步行距離(349.18±19.62),與對照組圣喬治呼吸問卷總分(47.58±6.72)、呼吸癥狀得分(46.90±6.93)、活動受限得分(49.65±8.78)、疾病影響得分(46.83±7.78)、6分鐘步行距離(285.24±19.79)相比,試驗組圣喬治呼吸問卷各項得分均低于對照組(P0.01),試驗組6分鐘步行距離高于對照組(P0.01)。4.患者情緒:干預6個月后,綜合性醫(yī)院焦慮抑郁量表試驗組的焦慮得分(7.42±2.88)及抑郁得分(6.04±1.82),與對照組的焦慮得分(9.34±3.37)及抑郁得分(7.52±2.02)相比,試驗組焦慮得分及抑郁得分均低于對照組(P0.01)。5.試驗組家庭支持效果:試驗組干預前家庭支持量表得分(10.92±2.86),與干預后家庭支持量表得分(13.22±1.28)相比,試驗組干預前家庭支持量表得分低于干預后(P0.01)。結論對COPD患者的家庭支持系統(tǒng)進行干預,實施以家庭為中心的慢病管理模式,能夠有效提高COPD患者的自我管理能力,有效改善其生活質量及情緒。在當前社區(qū)建設不完善的現(xiàn)狀下,醫(yī)療機構專業(yè)人員與患者及患者家屬共同建立有效的健康支持系統(tǒng),對促進COPD有效的慢病管理具有積極意義。
[Abstract]:Objective To establish a family-centered slow-disease management model by intervening on the family support system of patients with COPD, and to explore the effect of self-management ability, quality of life and mood in patients with COPD, with a view to improving the self-management ability of patients with COPD and improving their quality and mood. To provide scientific basis for establishing a more rational management mode of COPD. Methods 100 inpatients with COPD were selected according to the order of admission, the control group was collected from November 2013 to January 2015, the control group was administered with patient-centered slow disease management, and the test group was collected from February 2015 to February 2016. The test group intervened in the family support system of patients with COPD, and implemented a family-centred, slow-disease management of the patient, the patient's spouse and their children. There were 50 cases in the control group and the experimental group, and the intervention time of both groups was 6 months. Self-management scale, St George's breath questionnaire (SGRQ), 6-minute walk test (6MWT) and comprehensive hospital anxiety and depression scale (HAD) were used to evaluate the self-management ability, quality of life and mood of patients, and family support self-rating scale was used to evaluate the effect of family support intervention. All the data were processed by SPSS 17. 0 software package. The counting data were checked by cc2, and t-test was used for the measurement data. Results In this study, 50 patients with control group, including 36 males and 14 females, had an average age of 65. 46 and 6. 49 years old. Among the 50 patients, the mean age ranged from 66. 00 to 4.61 years old, among them 38 males and 12 females. Statistical results show: 1. The general data of two groups before intervention: sex, age, degree of culture, family monthly income, severity of disease, degree of dyspnea, self-control ability, activity ability, self-management ability, etc. were not statistically significant (P0.05). Patient's self-management ability: After 6 months of intervention, the symptom management score of the test group (29. 54/ 2. 40), daily life management score (49. 16/ 5. 59), emotion management score (45. 52/ 3.91), information management score (20. 28/ 2. 72), self-efficacy management score (32. 38, 3.21), The total scores of self-management (176,88 and 11.36) were compared with the control group symptom management scores (23.02/ 2.72), daily life management scores (41. 92/ 5. 01), emotional management scores (37. 34 and 4.87), information management scores (15. 88/ 3. 09), and self-efficacy management scores (24. 84 and 3. 84). Compared with the control group (P0.01), the self-management score of the test group was higher than that of the control group (P0.01). Patient's quality of life: After 6 months of intervention, the total score of St. George's Respiratory Questionnaire (37. 59/ 9. 03), respiratory symptom score (37. 5, 8. 64), Activity-limited score (37. 6, 11. 18), Disease Impact Score (37. 5, 10. 81), 6-minute walking distance (349. 18, 19. 62), were performed. Compared with control group St. George's respiratory questionnaire total score (47. 58/ 6. 72), respiratory symptom score (46. 90, 6.93), activity limited score (49. 65/ 8. 78), disease impact score (46. 83-7.78), 6-minute walking distance (285.24/ 19. 79), The scores of St George's breath questionnaire were lower than that in the control group (P0.01), and the walking distance of the test group was higher than that of the control group (P0.01). Patient mood: After 6 months of intervention, the anxiety score (7.42% 2.88) and depression score (6. 04/ 1. 82) of the comprehensive hospital anxiety and depression scale test group were compared with those of the control group (9.34 vs 3.37) and depression score (7.52/ 2.02). The scores of anxiety and depression were lower in the test group than in the control group (P0.01). The results of family support in test group: The scores of family support scale (10.92/ 2.86) before intervention were lower than that of intervention group (P0.05), and the scores of family support scale before intervention were lower than that of intervention group (P0.01). Conclusion The family support system of COPD patients can effectively improve the self-management ability of patients with COPD and improve their quality of life and mood effectively. In the current situation of imperfect community construction, the professional staff of medical institutions jointly establish an effective health support system with the patients and their families, which is of positive significance to the management of slow disease which is effective for the treatment of COPD.
【學位授予單位】：青島大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R473.5
本文編號：2308927
[Abstract]:Objective To establish a family-centered slow-disease management model by intervening on the family support system of patients with COPD, and to explore the effect of self-management ability, quality of life and mood in patients with COPD, with a view to improving the self-management ability of patients with COPD and improving their quality and mood. To provide scientific basis for establishing a more rational management mode of COPD. Methods 100 inpatients with COPD were selected according to the order of admission, the control group was collected from November 2013 to January 2015, the control group was administered with patient-centered slow disease management, and the test group was collected from February 2015 to February 2016. The test group intervened in the family support system of patients with COPD, and implemented a family-centred, slow-disease management of the patient, the patient's spouse and their children. There were 50 cases in the control group and the experimental group, and the intervention time of both groups was 6 months. Self-management scale, St George's breath questionnaire (SGRQ), 6-minute walk test (6MWT) and comprehensive hospital anxiety and depression scale (HAD) were used to evaluate the self-management ability, quality of life and mood of patients, and family support self-rating scale was used to evaluate the effect of family support intervention. All the data were processed by SPSS 17. 0 software package. The counting data were checked by cc2, and t-test was used for the measurement data. Results In this study, 50 patients with control group, including 36 males and 14 females, had an average age of 65. 46 and 6. 49 years old. Among the 50 patients, the mean age ranged from 66. 00 to 4.61 years old, among them 38 males and 12 females. Statistical results show: 1. The general data of two groups before intervention: sex, age, degree of culture, family monthly income, severity of disease, degree of dyspnea, self-control ability, activity ability, self-management ability, etc. were not statistically significant (P0.05). Patient's self-management ability: After 6 months of intervention, the symptom management score of the test group (29. 54/ 2. 40), daily life management score (49. 16/ 5. 59), emotion management score (45. 52/ 3.91), information management score (20. 28/ 2. 72), self-efficacy management score (32. 38, 3.21), The total scores of self-management (176,88 and 11.36) were compared with the control group symptom management scores (23.02/ 2.72), daily life management scores (41. 92/ 5. 01), emotional management scores (37. 34 and 4.87), information management scores (15. 88/ 3. 09), and self-efficacy management scores (24. 84 and 3. 84). Compared with the control group (P0.01), the self-management score of the test group was higher than that of the control group (P0.01). Patient's quality of life: After 6 months of intervention, the total score of St. George's Respiratory Questionnaire (37. 59/ 9. 03), respiratory symptom score (37. 5, 8. 64), Activity-limited score (37. 6, 11. 18), Disease Impact Score (37. 5, 10. 81), 6-minute walking distance (349. 18, 19. 62), were performed. Compared with control group St. George's respiratory questionnaire total score (47. 58/ 6. 72), respiratory symptom score (46. 90, 6.93), activity limited score (49. 65/ 8. 78), disease impact score (46. 83-7.78), 6-minute walking distance (285.24/ 19. 79), The scores of St George's breath questionnaire were lower than that in the control group (P0.01), and the walking distance of the test group was higher than that of the control group (P0.01). Patient mood: After 6 months of intervention, the anxiety score (7.42% 2.88) and depression score (6. 04/ 1. 82) of the comprehensive hospital anxiety and depression scale test group were compared with those of the control group (9.34 vs 3.37) and depression score (7.52/ 2.02). The scores of anxiety and depression were lower in the test group than in the control group (P0.01). The results of family support in test group: The scores of family support scale (10.92/ 2.86) before intervention were lower than that of intervention group (P0.05), and the scores of family support scale before intervention were lower than that of intervention group (P0.01). Conclusion The family support system of COPD patients can effectively improve the self-management ability of patients with COPD and improve their quality of life and mood effectively. In the current situation of imperfect community construction, the professional staff of medical institutions jointly establish an effective health support system with the patients and their families, which is of positive significance to the management of slow disease which is effective for the treatment of COPD.
【學位授予單位】：青島大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R473.5
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