CAJ | 학술논문

目的探讨多学科合作延续护理对慢性阻塞性肺疾病(COPD)患者生命质量的影响.方法选择2012年12月至2014年4月住院病情趋稳定即将出院的符合入选标准的COPD患者,便利抽取实验病区70例,完成随访64例(实验组);对照病区61例,完成随访50例(对照组).对照组采用常规出院指导,实验组采用多学科合作延续护理.调查2组干预前后生命质量问卷(SGRQ)得分、呼吸困难分级(MMRC)、体质量指数(BMI)、6 min步行试验距离(6MWD)等指标并比较.结果实验组患者在于预6个月后,其SGRQ总分及疾病症状、活动受限、疾病影响3个维度得分分别为(48.53±15.78)、(35.38±18.61)、(57.95±23.69)、(52.28± 15.27)分,较干预前的(61.29±15.22)、(52.03±15.60)、(68.96±18.72)、(62.87±21.26)分明显下降,差异有统计学意义,t值为2.918～5.487,P值均＜0.01;且实验组上述指标与对照组干预6个月后的(60.24±10.14)、(52.76±12.36)、(68.34±15.59)、(58.55±11.79)分比较明显降低,差异均有统计学意义,t值为-5.692～-2.399,P＜0.01或0.05.实验组患者在干预6个月后,6MWD为(267.46±64.64)m,较干预前的(169.42±48.46)m增加,差异有统计学意义,t=-9.709,P＜ 0.01,且效果优于对照组.实验组患者在干预6个月后,BMI、MMRC均较干预前改善,差异有统计学意义,Z值分别为-2.451、-6.901,P＜0.05或0.01,且2组间干预后比较,实验组MMRC好于对照组,差异有统计学意义,P＜0.01.结论多学科合作对出院后COPD患者延续的健康教育指导,可显著提高患者生命质量.
목적 탐토다학과합작연속호리대만성조새성폐질병(COPD)환자생명질량적영향.방법 선택2012년12월지2014년4월주원병정추은정즉장출원적부합입선표준적COPD환자,편리추취실험병구70례,완성수방64례(실험조);대조병구61례,완성수방50례(대조조).대조조채용상규출원지도,실험조채용다학과합작연속호리.조사2조간예전후생명질량문권(SGRQ)득분、호흡곤난분급(MMRC)、체질량지수(BMI)、6 min보행시험거리(6MWD)등지표병비교.결과 실험조환자재우예6개월후,기SGRQ총분급질병증상、활동수한、질병영향3개유도득분분별위(48.53±15.78)、(35.38±18.61)、(57.95±23.69)、(52.28± 15.27)분,교간예전적(61.29±15.22)、(52.03±15.60)、(68.96±18.72)、(62.87±21.26)분명현하강,차이유통계학의의,t치위2.918～5.487,P치균＜0.01;차실험조상술지표여대조조간예6개월후적(60.24±10.14)、(52.76±12.36)、(68.34±15.59)、(58.55±11.79)분비교명현강저,차이균유통계학의의,t치위-5.692～-2.399,P＜0.01혹0.05.실험조환자재간예6개월후,6MWD위(267.46±64.64)m,교간예전적(169.42±48.46)m증가,차이유통계학의의,t=-9.709,P＜ 0.01,차효과우우대조조.실험조환자재간예6개월후,BMI、MMRC균교간예전개선,차이유통계학의의,Z치분별위-2.451、-6.901,P＜0.05혹0.01,차2조간간예후비교,실험조MMRC호우대조조,차이유통계학의의,P＜0.01.결론 다학과합작대출원후COPD환자연속적건강교육지도,가현저제고환자생명질량.
Objective To explore the effects of the multidisciplinary cooperative continue nursing on the quality of life of patients with chronic obstructive pulmonary disease (COPD).Methods From December 2012 to April 2014,choosing hospitalized COPD patients who were of the stable and would soon discharge,and met the criteria standards.Convenient extracted 64 of 70 patients who completed follow-up as experimental group in one ward and 50 of 61patients who completed follow-up as control group in the other ward.Conventional discharge guidance were employed in the control group,while the continuation of care before discharge and after discharge 1,3,6 months were employed in the experimental group.Results Six months later,scores of quality of life scale and each dimension (symptoms,activities,influence) in the experimental group were (48.53±15.78) points,(35.38±18.61) points,(57.95 ±23.69) points,(52.28±15.27) points,which were significant lower than the former value (61.29±15.22) points,(52.03±15.60) points,(68.96±18.72) points,(62.87±21.26) points (t=2.918-5.487,P ＜0.01).After intervention,scores of experimental group were higher than that of control group which were (60.24±10.14) points,(52.76±12.36) points,(68.34±15.59) points,(58.55±11.79) points (t=-5.692--2.399,P ＜0.01 or 0.05).After intervention,the walking distance of 6 minutes of experimental group was (267.46±64.64) m,which was significant longer than that of before (169.42±48.46) m (t=-9.709,P＜ 0.01).Body mass index and grade of dyspnea were significant better in experimental group compared with before (Z=-2.451,-6.901,P ＜ 0.05 or 0.01).Besides,grade of dyspnea (MMRC) was also significant better than that in the control group (P＜0.01).Conclusions The quality of life of patients with COPD can be significantly improved by the multidisciplinary cooperative continue nursing education after discharge.