自我管理項目對COPD患者知識、信念及行為的影響研究
發(fā)布時間：2018-07-18 09:19
【摘要】：目的本研究通過對穩(wěn)定期COPD患者實施以家庭為背景的自我管理項目干預(yù),旨在幫助COPD患者獲得疾病相關(guān)知識及自我管理技能,提高患者對癥狀管理能力的自信心,即自我效能水平,進(jìn)而提高其呼吸困難癥狀管理相關(guān)行為依從性,促進(jìn)自我管理行為的建立,最終改善患者的健康狀態(tài)。 方法篩選自2009年4月-2010年4月由蘇州大學(xué)附屬第一醫(yī)院及第二醫(yī)院呼吸內(nèi)科病房出院的COPD病例,根據(jù)隨機(jī)對照原則,將研究對象分為干預(yù)組及對照組各34例。在患者出院后4周或4周以上,由經(jīng)過培訓(xùn)的研究小組成員到患者家中為干預(yù)組患者實施一對一的COPD自我管理項目干預(yù),干預(yù)時間共8周,每周1次課程,每次約1-2h,第1-6周進(jìn)行COPD自我管理理論課程,第7、8周實施康復(fù)行為指導(dǎo)。而對照組患者則給予一次呼吸內(nèi)科常規(guī)護(hù)理教育。在自我管理項目干預(yù)前、干預(yù)后2個月采用COPD健康知識問卷、COPD自我效能量表、COPD患者癥狀管理相關(guān)行為依從性調(diào)查表、呼吸困難癥狀評分及圣喬治呼吸問卷(St George's Respiratory Questionnaire, SGRQ)分別對患者的知識、信念及行為、行為結(jié)果做資料評估。采用SPSS16.0統(tǒng)計軟件對數(shù)據(jù)資料進(jìn)行統(tǒng)計分析。 結(jié)果自我管理項目干預(yù)后2個月,干預(yù)組患者健康知識總分(t=-11.659,P=0.000)；干預(yù)后自我效能總分(t=-9.509,P=0.000)、呼吸困難管理維度(t=-9.528,P=0.000)、情緒維度(t=--7.704,P=0.000)、體力活動維度(t=-7.043,P=0.000)、環(huán)境與溫度維度(t=-9.259,P=0.000)、安全行為維度(t=-7.127,P=0.000)均較干預(yù)前顯著提高；而對照組在干預(yù)前后上述資料得分均無顯著差異(P0.05)。患者在癥狀管理相關(guān)行為的四個方面即呼吸功能鍛煉(Z=-4.852,P=0.000)、運動鍛煉(Z=-3.947,P=0.000)、藥物吸入(Z=-4.852,P=0.000)及家庭氧療(Z=-3.145,P=0.002)的依從性較干預(yù)前顯著提高,平均家庭氧療時間明顯延長(t=0.749,P=0.000),干預(yù)前后資料間有顯著差異(P0.05);而對照組上述資料得分差異無統(tǒng)計學(xué)意義(P0.05)。干預(yù)后MRC(Medical Research Council Dyspnea Scale)評分較干預(yù)前明顯改善(z=-2.236,P=0.025),而Brog評分比較(t=0.754,P0.05)無顯著差異。干預(yù)組患者自我管理項目干預(yù)后2個月,SGRQ(St.George's respir atory Questionnaire)總分(t=4.740,P=0.000),癥狀(t=3.236,P=0.000),活動能力(t=2.374,P=0.000),社會心理(t=4.445,P=0.000)得分均較干預(yù)前明顯改善；而對照組患者SGRQ總分及各維度評分差異均無統(tǒng)計學(xué)意義(P0.05)。 結(jié)論1. COPD患者的健康知識水平普遍較低；自我效能總體處于中低水平；患者的呼吸困難癥狀管理相關(guān)行為依從性較差。2.自我管理項目干預(yù)有效提高了COP D患者的健康知識水平；增強(qiáng)了患者對呼吸困難癥狀管理的自信心；進(jìn)而提高了患者癥狀管理相關(guān)行為依從性,促進(jìn)了自我管理行為的建立。3.自我管理項目干預(yù)有利于改善患者的呼吸困難癥狀,最終提高患者健康相關(guān)生存質(zhì)量。
[Abstract]:Objective the purpose of this study was to help COPD patients acquire disease related knowledge and self-management skills, and improve their confidence in symptom management ability by implementing family background self-management project intervention to stable COPD patients. That is, self-efficacy level, and then improve their breathing difficulties symptoms management related behavior compliance, promote the establishment of self-management behavior, and ultimately improve the health status of patients. Methods from April 2009 to April 2010, patients with COPD were selected and discharged from the first affiliated Hospital and the second Hospital of Suzhou University. According to the principle of random control, the subjects were divided into intervention group and control group respectively. After the patient was discharged from hospital for 4 weeks or more, one to one COPD self-management program was carried out in the intervention group by the trained members of the research team. The intervention lasted 8 weeks and was taught once a week. Each time about 1-2 hours, 1-6 weeks of COPD self-management theory course, 7 weeks 8 weeks to carry out rehabilitation behavior guidance. The patients in the control group were given routine nursing education in respiratory medicine. Before and 2 months after intervention, COPD self-efficacy scale was used to evaluate the behavior compliance of COPD patients. The scores of dyspnea symptoms and St George's Respiratory questionnaire (SGRQ) were used to evaluate the patients' knowledge, beliefs and behaviors. SPSS 16.0 statistical software was used to analyze the data. Results the total score of health knowledge of patients in the intervention group was 0.000 (t = 11.659) 2 months after the intervention of self-management project. After intervention, the total score of self-efficacy was 0.000, the management dimension of dyspnea was 0.000, the emotional dimension was 7.704P0.000, the physical activity dimension was 0.000, the environment and temperature dimension was 0.000, and the safe behavior dimension was 7.127P0.000. There was no significant difference in the scores of the above data before and after intervention in the control group (P0.05). The compliance of patients in four aspects of symptoms management related behaviors, namely, respiratory function exercise (ZP0. 000), exercise (ZC- 3. 947 P0. 000), drug inhalation (ZC- 4. 852P0. 000) and family oxygen therapy (ZA- 3. 145 P0. 002), was significantly increased compared with that before intervention. The average time of family oxygen therapy was significantly prolonged (t0. 749%), and there was significant difference between the data before and after intervention (P0.05), while in the control group, there was no significant difference in the above data score (P0.05). After intervention, the MRC (Medical Research Council Dyspnea scale) score was significantly improved compared with that before the intervention (zhi-2.236), but there was no significant difference in Brog score (t0. 754P 0.05). In the intervention group, two months after intervention, the total score of SGRQ (St. George's respir atory quionnaire) (t = 4.740), symptoms (t = 3.236), activity ability (t = 2.374) and social psychology (t = 4.445P0. 000) were significantly improved compared with those before intervention, but there was no significant difference in RQ total score and dimension scores between the control group and the control group (P0.05). Conclusion 1. COPD patients' health knowledge level is generally low; self-efficacy is generally in the low and low level; patients with dyspnea symptoms management related behavior compliance is poor. 2. The intervention of self-management project can effectively improve the health knowledge level of patients with cop, enhance the self-confidence of patients with dyspnea symptoms management, and further improve the compliance of patients with symptoms management related behavior, and promote the establishment of self-management behavior. 3. Self-management program intervention can improve patients' dyspnea symptoms and ultimately improve their health-related quality of life.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R563.9
本文編號：2131461
[Abstract]:Objective the purpose of this study was to help COPD patients acquire disease related knowledge and self-management skills, and improve their confidence in symptom management ability by implementing family background self-management project intervention to stable COPD patients. That is, self-efficacy level, and then improve their breathing difficulties symptoms management related behavior compliance, promote the establishment of self-management behavior, and ultimately improve the health status of patients. Methods from April 2009 to April 2010, patients with COPD were selected and discharged from the first affiliated Hospital and the second Hospital of Suzhou University. According to the principle of random control, the subjects were divided into intervention group and control group respectively. After the patient was discharged from hospital for 4 weeks or more, one to one COPD self-management program was carried out in the intervention group by the trained members of the research team. The intervention lasted 8 weeks and was taught once a week. Each time about 1-2 hours, 1-6 weeks of COPD self-management theory course, 7 weeks 8 weeks to carry out rehabilitation behavior guidance. The patients in the control group were given routine nursing education in respiratory medicine. Before and 2 months after intervention, COPD self-efficacy scale was used to evaluate the behavior compliance of COPD patients. The scores of dyspnea symptoms and St George's Respiratory questionnaire (SGRQ) were used to evaluate the patients' knowledge, beliefs and behaviors. SPSS 16.0 statistical software was used to analyze the data. Results the total score of health knowledge of patients in the intervention group was 0.000 (t = 11.659) 2 months after the intervention of self-management project. After intervention, the total score of self-efficacy was 0.000, the management dimension of dyspnea was 0.000, the emotional dimension was 7.704P0.000, the physical activity dimension was 0.000, the environment and temperature dimension was 0.000, and the safe behavior dimension was 7.127P0.000. There was no significant difference in the scores of the above data before and after intervention in the control group (P0.05). The compliance of patients in four aspects of symptoms management related behaviors, namely, respiratory function exercise (ZP0. 000), exercise (ZC- 3. 947 P0. 000), drug inhalation (ZC- 4. 852P0. 000) and family oxygen therapy (ZA- 3. 145 P0. 002), was significantly increased compared with that before intervention. The average time of family oxygen therapy was significantly prolonged (t0. 749%), and there was significant difference between the data before and after intervention (P0.05), while in the control group, there was no significant difference in the above data score (P0.05). After intervention, the MRC (Medical Research Council Dyspnea scale) score was significantly improved compared with that before the intervention (zhi-2.236), but there was no significant difference in Brog score (t0. 754P 0.05). In the intervention group, two months after intervention, the total score of SGRQ (St. George's respir atory quionnaire) (t = 4.740), symptoms (t = 3.236), activity ability (t = 2.374) and social psychology (t = 4.445P0. 000) were significantly improved compared with those before intervention, but there was no significant difference in RQ total score and dimension scores between the control group and the control group (P0.05). Conclusion 1. COPD patients' health knowledge level is generally low; self-efficacy is generally in the low and low level; patients with dyspnea symptoms management related behavior compliance is poor. 2. The intervention of self-management project can effectively improve the health knowledge level of patients with cop, enhance the self-confidence of patients with dyspnea symptoms management, and further improve the compliance of patients with symptoms management related behavior, and promote the establishment of self-management behavior. 3. Self-management program intervention can improve patients' dyspnea symptoms and ultimately improve their health-related quality of life.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2012
【分類號】：R563.9
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