以家庭为基础的信息-动机-行为技巧管理模式在COPD患者随访管理中的运用

摘要

Objective To explore the application value of family-based information-motivation-behavioral skills model (IMB) in follow-up management of chronic obstructive pulmonary disease(COPD) patients. Methods 72 cases of COPD patients were randomly divided into the intervention group and the control group, each group had 36 cases. Conven-tional discharge management model was performed in the control group and family-based IMB skills model was per-formed in the intervention group, with a follow-up period of 3 months. For patients in both groups, their compliance to pulmonary rehabilitation training, changes of lung function, 6-minute walking distance (6MWD) and quality of life in-dexes before and after intervention were observed. Results The full completion rate of rehabilitation training was 47.22%in the intervention group, which was significantly higher than the rate of 11.11% in the control group, with sta-tistically significant difference (P< 0.05). In terms of lung function and exercise tolerance, FEV1%FVC, FEV1%Pre, MVV and 6MWD of patients in the intervention group after intervention were obviously higher than those before inter-vention and control group in the same period (P<0.05). Regarding to quality of life, symptom score, activity score, im-pact score and total score of patients in the intervention group after intervention were significantly lower than those be-fore intervention and control group in the same period (P<0.05). Conclusion The family-based IMB follow-up man-agement model can significantly increase COPD patientsˊcompliance to rehabilitation training, improve their lung func-tion status, quality of life, promote recovery.%目的 探讨以家庭为基础的信息-动机-行为技巧管理模式(IMB)在慢性阻塞性肺疾病(COPD)患者随访管理中的运用价值.方法将72例COPD患者随机分为干预组和对照组,各36例,对照组采用常规出院管理模式,干预组采用以家庭为基础的IMB随访管理模式,随访期为3个月.收集两组患者进行肺康复锻炼的依从性,干预前后肺功能、6 min步行距离(6MWD)及生存质量指标变化情况.结果干预组患者进行康复锻炼完全完成率为47.22%,明显高于对照组的11.11%,差异有统计学意义(P<0.05);在肺功能方面及运动耐力方面,干预后干预组患者的1秒用力呼气容积/用力肺活量、1秒用力呼气容积/预计值、每分钟最大通气量和6MWD均明显高于同组干预前及对照组同期水平(P<0.05);在生活质量方面,干预后干预组患者症状评分、活动评分、影响评分和总分均明显低于同组干预前及对照组同期水平(P<0.05).结论以家庭为基础的IMB随访管理模式,能够明显提升COPD患者进行康复锻炼的依从性,改善患者的肺功能状态和生存质量,促进患者康复.