CAJ | 학술논문

目的：探讨冠状动脉旁路移植术（CABG）患者疾病不确定感水平及其对呼吸功能锻炼依从性及术后康复的影响。方法采用Mishel疾病不确定感量表、自编呼吸功能锻炼依从性量表对108例CABG患者进行评估，分析患者疾病不确定感与呼吸功能锻炼依从性之间的相关性，并根据患者疾病不确定感情况分为得分偏高组、得分中等组及得分偏低组，分析3组患者呼吸功能锻炼依从性、术后监护时间、术后呼吸机使用时间、术后住院时间、6 min步行试验（6MWD）、左室射血分数（LVEF）的差异。结果 CABG患者的疾病不确定感处于中等水平(95.51±9.48),与呼吸功能锻炼依从性呈负相关(r=-0.926, P<0.01)；疾病不确定感得分偏低组的术后呼吸机使用时间、术后监护时间少于得分中等组及得分偏高组，其呼吸功能锻炼依从性、术后6MWD、术后LVEF优于得分中等组及得分偏高组。结论医务人员应采取针对性的干预措施降低患者的疾病不确定感，增强呼吸功能锻炼依从性，减少术后并发症，促进患者早日康复。
목적：탐토관상동맥방로이식술（CABG）환자질병불학정감수평급기대호흡공능단련의종성급술후강복적영향。방법채용Mishel질병불학정감량표、자편호흡공능단련의종성량표대108례CABG환자진행평고，분석환자질병불학정감여호흡공능단련의종성지간적상관성，병근거환자질병불학정감정황분위득분편고조、득분중등조급득분편저조，분석3조환자호흡공능단련의종성、술후감호시간、술후호흡궤사용시간、술후주원시간、6 min보행시험（6MWD）、좌실사혈분수（LVEF）적차이。결과 CABG환자적질병불학정감처우중등수평(95.51±9.48),여호흡공능단련의종성정부상관(r=-0.926, P<0.01)；질병불학정감득분편저조적술후호흡궤사용시간、술후감호시간소우득분중등조급득분편고조，기호흡공능단련의종성、술후6MWD、술후LVEF우우득분중등조급득분편고조。결론의무인원응채취침대성적간예조시강저환자적질병불학정감，증강호흡공능단련의종성，감소술후병발증，촉진환자조일강복。
Objective To explore the influence of uncertainty in illness in compliance of respiratory function exer-cise and rehabilitation after surgery in patients with coronary artery bypass graft (CABG) surgery. Methods Mishel uncer-tainty in illness scale and compliance of respiratory function exercise scale were used to collect data in 108 patients with CABG. The correlation of the uncertainty in illness and compliance of respiratory function exercise was analyzed. Patients were divided into three groups (high score, medium score and low score groups) according to the detection of uncertainty in illness. Values of compliance of respiratory function exercise, postoperative care time, postoperative ventilation time, postop-erative hospital stay duration, 6-min walking test (6MWD) and left ventricular ejection fraction (LVEF) were compared be-tween three groups. Results The uncertainty in illness was in medium level (95.51±9.48) in patients with CABG surgery, which was negatively correlated with compliance of respiratory function exercise (r=-0.926, P<0.01). The postoperative venti-lation time and postoperative care time were less in low score group than those of medium score group and high score group. The compliance of respiratory function exercise, 6-min walking test and postoperative LVEF were better in low score group than those of medium score group and high score group. Conclusion Medical personnel should take targeted interventions to reduce the uncertainty in illness in patients, enhance the compliance of respiratory function exercise, reduce the postopera-tive complications and promote early recovery of patients.