郭晓红



家庭疾病管理理念
对COPD患者自护能力、自我效能及家属配合率的影响

郭晓红

【摘要】目的 探讨家庭疾病管理理念对慢性阻塞性肺疾病（COPD）患者自护能力、自我效能及家属配合率的影响。方法 选取2011年4月～2013年10月于我院入院，经临床、影像学检查确诊为COPD的患者98例为研究对象，抽签随机分为观察组和对照组，两组均49例。入院后对照组配合医师进行传统门诊护理和治疗，观察组在对照组基础上进行COPD疾病管理理念宣教，均干预2个月，干预结束根据COPD相关知识及行为指标设定相应调查表，比较两组出院前后自护能力及家属配合率，并应用一般自我效能感量表（GSES）评价出院前后患者自我效能感。结果 出院后观察组家属配合率为83.7%，高于对照组的53.1%（P＜0.05）；出院后观察组患者自护能力（18.45±1.64）分及GSES评分（36.28±2.37）分，高于对照组的（11.36±3.48）分、（19.04±2.21）分（P＜0.05）。结论 对COPD家庭进行疾病管理理念教育，可以有效提升患者自我护理能力，增强其自我效能感，改善生活质量，进而控制COPD疾病进展，对提升预后有重要意义。

【关键词】家庭疾病管理理念；COPD；自护能力；自我效能；家属配合率

Objective To investigate the effect of family disease management concept on self-nursing ability，self-efficacy and cooperation rate of family members in patients with chronic obstructive pulmonary disease （COPD）. Methods 98 cases of patients diagnosed with COPD by clinical and imaging examination who were admitted in our hospital between April 2011 and October 2013 were selected as study objects and were randomized into observation group and control group，49 cases in each. After admission，the control group received traditional outpatient nursing and treatment in coordination with physicians；On the basis of the control group，the observation group received education of COPD management concept. Both of the two groups were intervened for 2 months. After the end of intervention，according to COPD related knowledge and behavior indexes，the corresponding questionnaires were designed tocompare the self-nursing ability and cooperation rate of family members before and after discharge. Besides，the General Self Efficacy Scale（GSES） was used to evaluate the self-efficacy of patients before and after discharge. Results After discharge，cooperation rate of family members in the observation group （83.7%）was significantly higher than that in the control group （53.1%）（P＜0.05）. The scores of self-nursing ability （18.45±1.64） and GSES （36.28±2.37）in observation group after discharge were significantly higher than those in control group ［（11.36±3.48），（19.04±2.21）］（P＜0.05）. Conclusion To give patients with COPD family disease management concept education can effectively improve patients' self-nursing ability，enhance their self-efficacy，improve the quality of life and control the progression of COPD，which is of great significance in improving the prognosis

【Key words】 Family disease management concept，COPD，Self-nursing ability，Self-efficacy，Cooperation rate of family members

慢性阻塞性肺疾病（COPD）是内科常见的慢性肺部疾病，主要由不完全可逆的气流阻塞所致，患者病情常呈慢性进展，伴呼吸道高反应性，近年来由于空气污染、职业粉尘、吸烟等诱因使COPD发病率、致残率、死亡率逐年上升，发病率高达9%，且患者因肺功能下降，表现为气短或呼吸困难［1-2］。随疾病发展，COPD患者心肺功能严重受损，可进一步发展为肺心病和呼吸衰竭等常见慢性疾病，而在感染、吸烟、失眠等综合作用下，会诱发COPD急性发作，甚至出现心力衰竭、呼吸衰竭等并发症，严重影响患者生活质量［3-4］。……