【摘要】：背景:慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease,COPD)患者常存在低氧血癥,不僅影響患者的生理功能,而且對心理健康和生活質(zhì)量造成嚴(yán)重影響。長程家庭氧療可以糾正低氧血癥、改善預(yù)后、提高生活質(zhì)量,然而目前COPD患者長程家庭氧療的現(xiàn)狀堪憂,針對長程家庭氧療的干預(yù)多是給予知識,忽視了信念對行為改變的重要性。HBM(Health Belief Model,HBM)通過使患者樹立健康的信念,進而形成健康的行為,為促進行為的改變提供了理論依據(jù)。目的:評價基于HBM的干預(yù)措施對提高COPD患者長程家庭氧療信念和長程家庭氧療行為的有效性。方法:本研究屬于類實驗性研究,于2016年8月至2017年4月,便利選取北京北京大學(xué)首鋼醫(yī)院和中國醫(yī)科大學(xué)航空總醫(yī)院呼吸內(nèi)科病房即將出院的COPD患者78例。首鋼醫(yī)院的研究對象按病區(qū)進行分組,航空總醫(yī)院的研究對象按時間先后進行分組,干預(yù)組和對照組各39例。干預(yù)組研究對象接受基于HBM的干預(yù)措施,并發(fā)放長程家庭氧療知識手冊、講解并演示長程家庭氧療步驟。對照組研究對象接受常規(guī)出院教育,包括發(fā)放和講解知識手冊并解答患者疑問。在干預(yù)前、干預(yù)完成時、干預(yù)后1個月、干預(yù)后3個月,采用長程家庭氧療健康信念問卷和長程家庭氧療執(zhí)行情況問卷分別對兩組研究對象的長程家庭氧療信念和長程家庭氧療行為進行測評,患者平均每日吸氧時間采用自我報告形式。結(jié)果:本研究共75例研究對象完成資料收集,其中干預(yù)組38例,對照組37例。研究結(jié)果顯示:(1)干預(yù)完成時、干預(yù)后1個月、干預(yù)后3個月,長程家庭氧療信念總分顯著高于同期的對照組(P0.05),且顯著高于干預(yù)前(P0.008);(2)干預(yù)組與對照組比較,干預(yù)組研究對象在干預(yù)后各時點的長程家庭氧療行為得分和平均每日吸氧時間均顯著高于同期對照組(P0.05),且顯著高于干預(yù)前(P0.008)。結(jié)論:在COPD人群中,實施基于HBM的干預(yù)措施對提高患者長程家庭氧療信念和長程家庭氧療行為是有效的。HBM從信念形成的角度出發(fā),為提高COPD患者的長程家庭氧療行為提供了新的途徑。
[Abstract]:Background: chronic obstructive pulmonary disease (Chronic Obstructive Pulmonary Disease,COPD) patients often have hypoxemia, which not only affects the physiological function of patients, but also has a serious impact on mental health and quality of life. Long-range family oxygen therapy can correct hypoxemia, improve prognosis and improve the quality of life. However, the current situation of long-term family oxygen therapy in COPD patients is worrying, the intervention for long-term family oxygen therapy is to give knowledge. Ignoring the importance of belief to behavior change (. HBM (Health Belief Model,HBM) provides a theoretical basis for promoting behavior change by enabling patients to establish healthy beliefs and then to form healthy behaviors. Objective: to evaluate the effectiveness of HBM-based intervention in improving long-range family oxygen therapy beliefs and long-range home oxygen therapy behaviors in patients with COPD. Methods: from August 2016 to April 2017, 78 COPD patients were selected from Shougang Hospital of Peking University and General Hospital of Aeronautical General Hospital of China Medical University. The subjects in Shougang Hospital were grouped according to the disease area, and those in Aviation General Hospital were divided into three groups according to time, 39 cases in the intervention group and 39 cases in the control group. The subjects of the intervention group accepted the intervention measures based on HBM, and issued the knowledge manual of long range family oxygen therapy to explain and demonstrate the long range family oxygen therapy steps. Subjects in the control group received routine discharge education, including issuing and explaining knowledge manuals and answering patients' questions. Before the intervention, when the intervention was completed, 1 month after the intervention, 3 months after the intervention, The long range family oxygen therapy beliefs and the long range family oxygen therapy behaviors of the two groups were measured by the long range Family oxygen Therapy Health belief questionnaire and the long range Family oxygen Therapy performance questionnaire, respectively. The average daily oxygen intake time of the patients was self-reported. Results: a total of 75 subjects completed the data collection, including 38 cases in the intervention group and 37 cases in the control group. The results showed that: (1) at the end of the intervention, 1 month after the intervention and 3 months after the intervention, the total score of long-term family oxygen therapy belief was significantly higher than that of the control group (P0.05) and significantly higher than that before the intervention (P0.008); (2) compared with the control group, the scores of long-term family oxygen therapy behavior and the average daily oxygen inhalation time in the intervention group were significantly higher than those in the control group (P0.05) and significantly higher than those before the intervention (P0.008). Conclusion: in COPD population, the intervention based on HBM is effective to improve patients' long-term family oxygen therapy belief and long-term family oxygen therapy behavior. HBM starts from the perspective of belief formation. It provides a new way to improve the long-range home oxygen therapy in COPD patients.
【學(xué)位授予單位】：北京協(xié)和醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R473.5

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