沈丽红

摘 要 目的：探索精細化社区管理对慢性阻塞性肺疾病（COPD）患者心理状态的影响。方法：选取2019年3月至2020年3月在社区卫生服务中心门诊治疗的90例COPD患者，采用随机数字表的方法分为实验组及常规组各45例，实验组中有男性16例，女性29例；平均年龄（64.71±6.60）岁；平均病程（4.56±2.40）年。常规组中有男性19例，女性26例；平均年龄（66.31±6.83）岁；平均病程（4.54±2.52）年。给予常规组患者基本社区护理，实验组患者在常规组的基础上接受精细化社区管理，管理期为6个月，比较两组管理前后的心理状况。结果：管理6个月后，实验组的12项一般健康问卷（GHQ-12）、Zung焦虑自评量表（SAS）和抑郁自评量表（SDS）评分均较前明显下降，且低于常规组，差异均均有统计学意义（P<0.05）；常规组管理前后3个量表评分的差异无统计学意义（P>0.05）。结论：精细社区管理能够缓解COPD患者的焦虑、抑郁情绪，改善生活质量。

关键词 慢性阻塞性肺疾病；精细化社区管理；焦虑；抑郁

中图分类号：R56 文献标志码：A 文章编号：1006-1533（2021）04-0054-04

Effect of fine community management on psychological status of patients with chronic obstructive pulmonary disease

SHEN Lihong

（Outpatient Nursing of Hongqiao Community Health Service Center of Changning District， Shanghai 200051， China）

ABSTRACT Objective： To explore the effect of fine community management on the psychological status of patients with chronic obstructive pulmonary disease（COPD）. Methods： A total of 90 patients with COPD who received outpatient treatment in Hongqiao Community Health Service Center from March 2019 to March 2020 were recruited， and with the random number table divided into an experimental group and a conventional group with 45 cases in each group， in the experimental group， there were 16 males and 29 females； the average age was （64.71±6.60） years； the average course of the disease was （4.56±2.40） years. In the conventional group， there were 19 males and 26 females； the average age was （66.31±6.83） years； the average course of the disease was （4.54±2.52） years. The patients in the conventional group were given basic community nursing， the patients in the experimental group received refined community management on the basis of the conventional group， and the management period was 6 months. The psychological status of the two groups before and after management was compared. Results： After 6 months of management， the 12 items of general health questionnaire（GHQ-12）， Zung self-rating anxiety scale（SAS） and selfrating depression scale（SDS） scores of the experimental group were significantly lower than those before， and the conventional group， and the differences were all statistically significant（P<0.05）； there was no significant difference in the scores of the three scales before and after management in the conventional group（P>0.05）. Conclusion： Fine community management can alleviate the anxiety and depression of COPD patients and improve the quality of life.

KEY WORDS chronic obstructive pulmonary disease； fine community management； anxiety； depression

慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）是一种以持续气流受限为特征的，可以预防和治疗的肺部疾病，气流受限不完全可逆，并进行性加重。主要临床表现为慢性咳嗽、咳痰，伴有呼吸困难、气短、喘息、胸闷等症状。中国40岁及以上人群COPD患病率为9.4%[1]。COPD随着病程时间延长，病情逐渐的恶化，患者肺功能进行性减退，导致临床症状加重，并出现全身乏力和焦虑、抑郁情绪，严重影响患者日常生活和心理健康。精细化社区管理是有针对性的对COPD患者进行健康教育、康复指导、生活指导、心理干预，除了能提高患者治疗的依从性，减轻临床症状，延缓疾病进展外，还能减轻患者对于疾病的焦虑情绪，提高日常生活质量[2]。……