慢性阻塞性肺疾病患者護理醫(yī)生管理模式的探討及實踐
發(fā)布時間：2018-08-05 12:32
【摘要】：目的:探討慢性阻塞性肺疾病患者護理醫(yī)生管理模式,擬定出工作方案,為COPD患者提供綜合的、規(guī)范的、系統(tǒng)的個性化康復(fù)護理服務(wù),探討護理醫(yī)生管理模式對COPD患者生活質(zhì)量干預(yù)效果的影響。方法:結(jié)合我們國家現(xiàn)有的本地區(qū)醫(yī)療衛(wèi)生資源,配合我國特有的醫(yī)療衛(wèi)生體系,同時通過借鑒國外先進的臨床護理醫(yī)生管理模式、工作經(jīng)驗,制定護理醫(yī)生的工作方案,并應(yīng)用于COPD患者的康復(fù)護理過程中。從2013年3月----2013年8月在東阿縣人民醫(yī)院呼吸內(nèi)科住院的COPD患者中選擇80例患者,采取隨機分組的方法,將其分為對照組和干預(yù)組。干預(yù)組患者在住院期間臨床護理醫(yī)生對其實施康復(fù)護理及健康指導(dǎo),在出院后進行隨訪并跟蹤指導(dǎo),對照組患者采用以往呼吸系統(tǒng)疾病護理常規(guī)進行護理、治療。出院后對對照組、干預(yù)組患者均觀察隨訪半年。分別監(jiān)測并評價兩組患者入院時、出院時、出院后三個月及六個月時的肺功能檢查、生存質(zhì)量(SGRQ)、運動耐力(BODE指數(shù))、患者滿意度、出院六個月內(nèi)的平均醫(yī)療費、平均住院日、再次入院率等評價指標(biāo),懫用SPSS 17.0軟件包對數(shù)據(jù)進行分析處理,(P0.05)是有顯著性差異的判斷標(biāo)準(zhǔn)。結(jié)果:1.對兩組患者入院時一般性資料、肺功能的檢查指標(biāo)、SGRQ評分、BODE指數(shù)進行比較(P0.05),差異均無統(tǒng)計學(xué)意義。2.患者出院時各項指標(biāo)的比較:干預(yù)組患者的肺功能指標(biāo)明顯高于對照組(P0.05);對SGRQ評分結(jié)果進行比較,對照組病人的SGRQ總分及其組成部分(癥狀分、活動分、影響分)得分均高于干預(yù)組(P0.05);在BODE指數(shù)結(jié)果比較中,除了BIM指數(shù)(P0.05)外,其它指標(biāo)都具有統(tǒng)計學(xué)意義(P0.05);在患者滿意度調(diào)查的各項指標(biāo)中干預(yù)組明顯優(yōu)于對照組,具有統(tǒng)計學(xué)意義(P0.05)。3、出院三個月及六個月時各評價指標(biāo)的比較結(jié)果:干預(yù)組患者的肺功能指標(biāo)明顯高于對照組(P0.05);在SGRQ比較中,干預(yù)組患者SGRQ總分及各組成部分得分均低于同級對照組(P0.05);在BODE指數(shù)結(jié)果比較中,干預(yù)組各項指標(biāo)明顯優(yōu)于對照組,具有統(tǒng)計學(xué)意義(P0.05);在患者滿意度調(diào)查的各項指標(biāo)中干預(yù)組明顯優(yōu)于對照組,具有統(tǒng)計學(xué)意義(P0.05)。干預(yù)組患者自入院至出院六個月內(nèi)的平均醫(yī)療費、平均住院日及再次入院率均低于對照組(P0.05),具有統(tǒng)計學(xué)意義。結(jié)論:通過護理醫(yī)生指導(dǎo)下的肺康復(fù)教育對慢性阻塞性肺疾病患者肺功能、SGRQ評分、BODE指數(shù)的影響,能有效減輕COPD患者的呼吸困難癥狀、增強活動耐力、改善營養(yǎng)狀況、有效提高了患者的滿意度和生活質(zhì)量,同時降低了患者平均醫(yī)療費、平均住院日、再次入院率。
[Abstract]:Objective: to explore the management mode of nursing doctors in patients with chronic obstructive pulmonary disease (COPD) and to draw up a working plan to provide comprehensive, standardized and systematic individualized rehabilitation nursing services for patients with COPD. To explore the effect of nursing doctor management mode on quality of life (QOL) intervention in patients with COPD. Methods: according to the existing medical and health resources of our country and the special medical and health system of our country, and by drawing lessons from the advanced management mode and working experience of clinical nursing doctors from abroad, we worked out the working plan of nursing doctors. And applied to the rehabilitation nursing process of COPD patients. From March 2013 to August 2013, 80 COPD patients were selected from Department of Respiratory Medicine, Donga County people's Hospital, and were randomly divided into control group and intervention group. The patients in the intervention group were given rehabilitation nursing and health guidance during hospitalization, followed up and followed up after discharge, while the patients in the control group were treated with routine nursing for respiratory diseases. The patients in the control group and the intervention group were followed up for half a year after discharge. Pulmonary function tests, quality of life (SGRQ),) exercise endurance (BODE index), patient satisfaction, average medical expenses within 6 months, average hospitalization days were monitored and evaluated at admission, 3 months and 6 months after discharge. The re-admission rate and other evaluation indexes were analyzed and processed by SPSS 17.0 software package. (P0.05) was the criterion of significant difference. The result is 1: 1. Two groups of patients on admission to the general data, pulmonary function test index of SGRQ scores and BODE index were compared (P0.05), the difference was not statistically significant. 2. Comparison of the indexes at discharge: the pulmonary function of the patients in the intervention group was significantly higher than that in the control group (P0.05); the total score of SGRQ and its components in the control group were compared with those in the control group (symptom score, activity score, P05). Impact scores were higher than the intervention group (P0.05); in the comparison of BODE index results, in addition to the BIM index (P0.05), other indicators were statistically significant (P0.05); in the patient satisfaction survey of the indicators of the intervention group was significantly better than the control group, There was statistical significance (P0.05) .3. the comparison of the evaluation indexes at 3 months and 6 months after discharge: the pulmonary function index of the intervention group was significantly higher than that of the control group (P0.05); in the comparison of SGRQ, the lung function index of the intervention group was significantly higher than that of the control group (P0.05). The total score of SGRQ and the scores of each component in the intervention group were lower than those in the control group (P0.05); in the comparison of the results of BODE index, the indexes of the intervention group were significantly better than those of the control group. There was statistical significance (P0.05); the intervention group was significantly better than the control group in the indicators of patient satisfaction survey (P0.05). The average medical expenses, average hospitalization days and readmission rate in the intervention group were lower than those in the control group (P0.05). Conclusion: the effect of pulmonary rehabilitation education under the guidance of nursing doctors on the pulmonary function and SGRQ score and bode index of patients with chronic obstructive pulmonary disease can effectively alleviate the symptoms of dyspnea, enhance activity tolerance and improve nutritional status in patients with COPD. It can effectively improve patients' satisfaction and quality of life, at the same time reduce patients' average medical expenses, average hospitalization days, and readmission rate.
【學(xué)位授予單位】：泰山醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R473.5
本文編號：2165808
[Abstract]:Objective: to explore the management mode of nursing doctors in patients with chronic obstructive pulmonary disease (COPD) and to draw up a working plan to provide comprehensive, standardized and systematic individualized rehabilitation nursing services for patients with COPD. To explore the effect of nursing doctor management mode on quality of life (QOL) intervention in patients with COPD. Methods: according to the existing medical and health resources of our country and the special medical and health system of our country, and by drawing lessons from the advanced management mode and working experience of clinical nursing doctors from abroad, we worked out the working plan of nursing doctors. And applied to the rehabilitation nursing process of COPD patients. From March 2013 to August 2013, 80 COPD patients were selected from Department of Respiratory Medicine, Donga County people's Hospital, and were randomly divided into control group and intervention group. The patients in the intervention group were given rehabilitation nursing and health guidance during hospitalization, followed up and followed up after discharge, while the patients in the control group were treated with routine nursing for respiratory diseases. The patients in the control group and the intervention group were followed up for half a year after discharge. Pulmonary function tests, quality of life (SGRQ),) exercise endurance (BODE index), patient satisfaction, average medical expenses within 6 months, average hospitalization days were monitored and evaluated at admission, 3 months and 6 months after discharge. The re-admission rate and other evaluation indexes were analyzed and processed by SPSS 17.0 software package. (P0.05) was the criterion of significant difference. The result is 1: 1. Two groups of patients on admission to the general data, pulmonary function test index of SGRQ scores and BODE index were compared (P0.05), the difference was not statistically significant. 2. Comparison of the indexes at discharge: the pulmonary function of the patients in the intervention group was significantly higher than that in the control group (P0.05); the total score of SGRQ and its components in the control group were compared with those in the control group (symptom score, activity score, P05). Impact scores were higher than the intervention group (P0.05); in the comparison of BODE index results, in addition to the BIM index (P0.05), other indicators were statistically significant (P0.05); in the patient satisfaction survey of the indicators of the intervention group was significantly better than the control group, There was statistical significance (P0.05) .3. the comparison of the evaluation indexes at 3 months and 6 months after discharge: the pulmonary function index of the intervention group was significantly higher than that of the control group (P0.05); in the comparison of SGRQ, the lung function index of the intervention group was significantly higher than that of the control group (P0.05). The total score of SGRQ and the scores of each component in the intervention group were lower than those in the control group (P0.05); in the comparison of the results of BODE index, the indexes of the intervention group were significantly better than those of the control group. There was statistical significance (P0.05); the intervention group was significantly better than the control group in the indicators of patient satisfaction survey (P0.05). The average medical expenses, average hospitalization days and readmission rate in the intervention group were lower than those in the control group (P0.05). Conclusion: the effect of pulmonary rehabilitation education under the guidance of nursing doctors on the pulmonary function and SGRQ score and bode index of patients with chronic obstructive pulmonary disease can effectively alleviate the symptoms of dyspnea, enhance activity tolerance and improve nutritional status in patients with COPD. It can effectively improve patients' satisfaction and quality of life, at the same time reduce patients' average medical expenses, average hospitalization days, and readmission rate.
【學(xué)位授予單位】：泰山醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R473.5
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