本文關(guān)鍵詞： 肺疾病 慢性阻塞性 急性加重期 運(yùn)動(dòng)自我效能感 肺康復(fù)　出處：《重慶醫(yī)科大學(xué)》2017年碩士論文　論文類(lèi)型：學(xué)位論文

【摘要】：目的:調(diào)查急性加重期慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者運(yùn)動(dòng)自我效能感及其影響因素;探討適用于COPD急性加重期患者的以運(yùn)動(dòng)訓(xùn)練為基礎(chǔ)的分級(jí)化肺康復(fù)的策略,并評(píng)估其有效性。方法:(1)采用方便抽樣對(duì)重慶醫(yī)科大學(xué)附屬第二醫(yī)院呼吸內(nèi)科門(mén)診及病房中確診為COPD急性加重期的126例患者進(jìn)行一般資料問(wèn)卷、運(yùn)動(dòng)自我效能感量表及社會(huì)支持評(píng)定量表調(diào)查。(2)使用隨機(jī)數(shù)字表法,將其中符合納入排除標(biāo)準(zhǔn)的68例COPD急性加重期住院患者分為康復(fù)組35例與對(duì)照組33例。對(duì)兩組均進(jìn)行常規(guī)的治療護(hù)理措施,而康復(fù)組在對(duì)此基礎(chǔ)上行分級(jí)化肺康復(fù)運(yùn)動(dòng)。對(duì)兩組治療前后的醫(yī)院焦慮抑郁量表、BODE指數(shù)以及COPD臨床問(wèn)卷得分以及變化幅度進(jìn)行比較。結(jié)果:(1)COPD急性加重期患者的運(yùn)動(dòng)自我效能感平均分為(79.97±19.78)分,屬于中等水平。多因素分析顯示,社會(huì)支持評(píng)價(jià)、其他疾病、年齡以及睡眠障礙是影響COPD急性加重期患者運(yùn)動(dòng)自我效能感的主要影響因素(t=5.351、3.469、-3.082、2.461,P0.01或0.05)。(2)COPD急性加重期患者分級(jí)化肺康復(fù)運(yùn)動(dòng)實(shí)驗(yàn)中共完成61例,康復(fù)組31例,對(duì)照組30例。干預(yù)后康復(fù)組醫(yī)院焦慮抑郁量表評(píng)分從基線的7.67±3.92到康復(fù)后的6.45±4.25(P0.01),BODE指數(shù)從7.58±2.11到康復(fù)后的7.10±2.33(P0.01),COPD臨床問(wèn)卷從基線的2.82±1.27到康復(fù)后的2.67±1.27(P0.01);實(shí)驗(yàn)組和對(duì)照組的變化幅度比較中BODE指數(shù)有統(tǒng)計(jì)學(xué)意義(P0.05)。而對(duì)照組前后變化幅度比較無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:(1)COPD急性加重期患者的運(yùn)動(dòng)自我效能感處于中等水平,亟待提高,更應(yīng)特別關(guān)注社會(huì)支持體系和對(duì)其他疾病的控制;(2)急性加重期COPD患者經(jīng)過(guò)分級(jí)化肺康復(fù)后可獲得心理狀態(tài)、運(yùn)動(dòng)能力及生活質(zhì)量的改善。
[Abstract]:Objective: to investigate the motor self-efficacy and its influencing factors in patients with chronic obstructive pulmonary disease of acute exacerbation of COPD, and to explore the strategies of graded pulmonary rehabilitation based on exercise training for patients with acute exacerbation of COPD. Methods: to evaluate its effectiveness, 126 patients with acute exacerbation of COPD in outpatient and ward department of Department of Respiratory Medicine, second affiliated Hospital of Chongqing Medical University were surveyed with general data questionnaire. Exercise self-efficacy scale and social support rating scale. 68 inpatients with acute exacerbation of COPD were divided into rehabilitation group (n = 35) and control group (n = 33). On the basis of this, the rehabilitation group was treated with graded pulmonary rehabilitation exercise. The BODE index of hospital anxiety and depression scale and the scores and changes of COPD clinical questionnaire were compared between the two groups before and after treatment. The average score of motor self-efficacy was 79.97 鹵19.78. Multivariate analysis shows that social support evaluation, other diseases, Age and sleep disorder were the main influencing factors of motor self-efficacy in patients with acute exacerbation of COPD. The scores of hospital anxiety and depression scale after intervention in rehabilitation group ranged from 7.67 鹵3.92 in baseline to 6.45 鹵4.25 in P0.01BDE index after rehabilitation from 7.58 鹵2.11 to 7.10 鹵2.33 P0.01 after rehabilitation from 2.82 鹵1.27 in baseline to 2.67 鹵1.27 in rehabilitation group, and the range of changes in experimental group and control group was significant. There was significant difference in BODE index between two groups (P 0.05), but there was no significant difference between control group (P 0.05) and control group (P 0.05). Conclusion the motor self-efficacy of patients with acute exacerbation of BODE is at a moderate level. We should pay more attention to the improvement of social support system and control of other diseases. The patients with COPD in acute exacerbation stage can obtain the improvement of mental state, motor ability and quality of life after grade lung rehabilitation.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R563.9

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