邢季伟 武燕燕 柴源

[摘要] 目的 观察FOCUS-PDCA模式对老年肌少症患者生活质量和日常活动能力的影响。 方法 选取2015年7月～2017年3月于北京友谊医院住院治疗的老年肌少症患者169例，采用随机数字表法分为对照组（85例）和观察组（84例）。对照组给予常规肌少症营养和运动宣教，观察组在对照组基础上，采用FOCUS-PDCA模式。采用Spitzer生活质量指数和改良Barthel量表评价干预前和干预3个月后两组的生活质量和日常生活能力并比较。结果 对照组干预前后生活质量日常生活状况、活动能力、生活感受、健康感受和家庭支持5个维度评分及总分比较，差异无统计学意义（P > 0.05）；观察组干预后生活质量各维度评分和总分均较干预前提高，且均高于对照组，差异有统计学意义（P < 0.05）。对照组干预前后ADL中10个项目（个人卫生，洗澡，进食，穿衣，大、小便控制，如厕，上下楼梯，床/椅转移，平地行走）评分及总分比较，差异无统计学意义（P > 0.05）；观察组干预后ADL中10个项目评分和总分均较干预前提高，且均高于对照组，差异有统计学意义（P < 0.05）。 结论 采用FOCUS-PDCA模式可以提高老年肌少症患者的生活质量和日常活动能力。

[關键词] FOCUS-FDCA模式；老年；肌少症；生活质量；生活能力

[中图分类号] R473.5 [文献标识码] A [文章编号] 1673-7210（2018）09（a）-0160-05

[Abstract] Objective To observe the influence of FOCUS-PDCA model on quality of life and activity of daily living for elder patients with sarcopenia. Methods From July 2015 to March 2017， in Beijing Friendship Hospital， Capital Medical University， 169 elder patients with sarcopenia were selected， they were divided into control group （85 cases） and observation group （84 cases） according to the random number table. The control group was given nutrition and exercise education， the observation group was given the FOCUS-PDCA model based on the control group. The quality of life and activity of daily living in two groups were evaluated and compared before and after the intervention for 3 months by Spitzer quality of index and Modified Barthel Idex. Results There was no statistically significant difference on 5 dimension score of living condition， mobility， life feeling， general health， family support， and total scores about quality of life in control group before and after intervention （P > 0.05）； the each dimension score and total scores of quality of life in observation group were higher after intervention than before intervention， and these were higher than those in control group， the differences were statistically significant （P < 0.05）. There was no statistically significant differences in 10 item scores （personal hygiene， bathing， eating， dressing， large， urine control， toilet， up and down stairs， bed/chair transfer， ground walking） and total scores of ADL in control groups before and after intervention （P > 0.05）； and the 10 item score and total scores of ADL in observation group after intervention were higher than before intervention， and these were higher than control group， the differences were statistically significant （P < 0.05）. Conclusion FOCUS-PDCA model can improve quality of life and activity of daily living for elder patients with sarcopenia.

[Key words] FOCUS-PDCA model； Elderly； Sarcopenia； Quality of life； Activity of daily living

研究发现[1-2]，65岁以上老年人肌少症患病率为5%～10%，80岁以上老年人患病率高达31.6%。临床研究[3]证实，肌少症增加了老年人跌倒和骨折的发生风险，降低了其活动能力和生活质量。因此，早发现、早诊断、并实施有效的干预措施是改善老年肌少症患者生存质量的关键[4]。FOCUS-PDCA程序，即持续质量改进模式，作为PDCA循环的进一步延伸和改进，其通过严谨的运转程序和多样的管理层次，能够更仔细地了解和分析程序中环节，以达到持续质量改进的目的[5]，现已应用于多个医学相关学科的管理中，均被证明是一种行之有效的方法[6-10]。由……