摘要
目的探讨呼吸专科护理门诊实施慢性阻塞性肺疾病(慢阻肺)个案管理的效果。方法选取2019年3月—2020年3月在汕头市中心医院呼吸与危重症医学科门诊就诊的符合入选标准的慢阻肺患者50例,由门诊专科护士实施个案管理,分析实施前、实施后6个月的体质指数(BMI)、第1秒用力呼气容量占预计值百分比(FEV1%预计值)、改良英国医学研究委员会呼吸问卷(mMRC)评分、6 min步行距离(6MWD)、慢阻肺患者自我评估测试(CAT)评分和圣乔治呼吸问卷(SGRQ)、基本生活活动能力(BADL)评分差异,同时分析个案管理后的用药依从性变化差异。结果实施个案管理后6个月患者mMRC评分[(1.9±1.2)比(1.4±1.1)分]、6MWD[(238.1±84.9)比(284.1±113.8)m]和CAT评分[(19.7±6.6)比(17.1±5.9)分]等呼吸困难程度、运动耐力、自觉症状等指标均有所改善(均P<0.05)。实施后6个月患者BADL评分[(87.8±5.4)比(90.0±7.5)分]、SGRQ总体评分[(48.0±7.5)比(45.0±6.9)分]也均有改善(均P<0.01)。患者随访1、3、6个月后用药依从性评分分别为(7.1±0.8)、(7.4±0.8)、(7.7±0.5)分(P<0.01)。结论实施呼吸专科护理门诊可以有效管理慢阻肺患者,提高患者用药依从性,从而改善患者的呼吸困难程度、自觉症状、自理能力和运动耐力等。
Objective To explore the effect of case management of chronic obstructive pulmonary disease(COPD)in the nurse-led clinics.Methods A total of 50 patients with COPD who met the selection criteria in the outpatient department of the respiratory department of Shantou Central Hospital were enrolled from March 2019 to March 2020.Case management was carried out by specialist nurses in the outpatient department.Body Mass Index(BMI),the forced expiratory volume in one second/predicted value ratio(FEV1%pred),modified British medical research council(mMRC),6-min walking distance(6MWD),COPD assessment test(CAT),and St.George Respiratory Questionnaire(SGRQ),basic activities of daily living(BADL)were compared before and after 6 months′case management.The difference of medication compliance after case management was also analyzed.Results There were statistically significant differences in the mMRC[(1.9±1.2)vs(1.4±1.1)points],6MWD[(238.1±84.9)vs(284.1±113.8)m]and CAT scores[(19.7±6.6)vs(17.1±5.9)points],which suggested the improvement of dyspnea,self-conscious symptoms and exercise performance in these patients(all P<0.05).The BADL scores[(87.8±5.4)vs(90.00±7.5)points]and the total score of SGRQ[(48.0±7.3)vs(45.0±6.9)points]were significantly different(both P<0.01).These indicators were improved after the implementation of case management.Patients were followed up for 1 month,3 months and 6 months,and the improvement of medication compliance score was statistically significant[(7.1±0.8)vs(7.4±0.8)vs(7.7±0.5)points](P<0.01).Conclusion The implementation of respiratory nursing clinic can effectively manage COPD patients,improve medication compliance of patients,so as to improve the degree of dyspnea,self-conscious symptoms,self-care ability and exercise endurance of patients.
作者
朱蔚仪
张淇钏
周玉华
苏秀烨
谢芬
纪晓霞
马少骅
Zhu Weiyi;Zhang Qichuan;Zhou Yuhua;Su Xiuye;Xie Fen;Ji Xiaoxia;Ma Shaohua(Department of Respiratory and Critical Care Medicine,Shantou Central Hospital,Shantou 515031,China;Nursing Department of Shantou Central Hospital,Shantou 515031,China)
出处
《中华健康管理学杂志》
CAS
CSCD
2022年第2期95-98,共4页
Chinese Journal of Health Management
基金
2018年广东省护理学会护理科研课题立项(第一批)(粤护字[2019]002号)。
关键词
肺疾病
慢性阻塞性
门诊病人
护理
个案管理
Pulmonary disease,chronic obstructive
Outpatients
Nursing care
Case management
