杨淑梅+等

[摘要] 目的 探讨临床护理路径对哮喘患者自我管理能力的影响。 方法 根据纳入标准，将224例支气管哮喘患者随机分为实验组和对照组，实验组进行包括自我护理水平的评估和干预、哮喘之家、记录“哮喘日记”、坚持随访等强调自我护理的临床护理路径，对照组采用常规健康教育和指导，随访患者出院时哮喘相关知识和技能的掌握情况、出院后2个月患者的哮喘控制测试量表（ACT）得分和复查率。 结果 ①两组患者的哮喘相关知识和技能得分情况分别为（93.84±4.71）分和（96.27±3.81）分，差异有统计学意义；②两组患者哮喘控制测量情况：完全控制为78.99%；部分控制为15.97%；未控制为5.04%，与对照组相比均有统计学意义；③两组患者的复诊率分别为：实验组74.79%和对照组52.34%，差异有统计学意义。 结论 临床护理路径可提高哮喘患者自我管理能力，值得在临床上推广。

[关键词] 临床护理路径；自我管理；哮喘

Influence of clinical nursing pathway on self-management abilities of patients with asthma

YANG Shumei WANG Lijun SUN Yu HU Haiyan ZHANG Min GUAN Shufen GAO Xue

The First Affiliated Hospital of Qiqihar Medical College， Qiqihar 161041，China

[Abstract] Objective To investigate the influence of clinical nursing pathway on the self-management abilities of patients with asthma. Methods According to the inclusion criteria， 224 patients with bronchial asthma were randomly divided into the experimental group and the control group. The experimental group implemented the clinical nursing pathway stressing self-nursing， such as evaluation and intervention of self-nursing levels， family of asthma， “asthma diary” recording and follow-up visits. The control group implemented conventional health education and guidance， and follow-up visits of mastery of asthma related knowledge and skills at hospital discharge and the patients asthma control test （ACT） scores and review rates 2 months after hospital discharge. Results ① The scores of asthma related knowledge and skills of the two groups of patients were （93.84±4.71） and （96.27±3.81）， with statistically significant difference； ② The asthma control measurement situation of the two groups of patients were 78.99% of total control， 15.97% of partial control and 5.04% of uncontrol， with statistically significant differences to the control group； ③ The recurrence rates of the experimental group and the control group were 74.79% and 52.34%， with statistically significant difference. Conclusion Clinical nursing pathway can improve the self-management abilities of the patients with asthma， thereby worthy of clinical promotion.

[Key words] Clinical nursing pathway； Self-management； Asthma

支气管哮喘具有不同程度的反复发作的支气管痉挛，主要由于多种炎性细胞对气道浸润导致[1，2]，其发病急促、反复发作而给患者带来极大的生理心理伤害，严重影响了患者的日常工作和生活。我国哮喘防治规范化推进从1995年开始，各地医院均逐渐按照世界卫生组织制定的全球哮喘防治创议（JINA）治疗患者，然而支气管哮喘实际的控制情况却不尽如人意[3]，因此，对支气管哮喘患者开展健康指导，能够更加有效地减少哮喘发作，缓解痛苦，提高患者生存质量[4]。而临床护理路径（clinical nursing pathway，CNP）是一种综合性的、跨学科的整体医疗护理工作模式[5]，能够显著提高护理效率和患者的满意度。……