摘要
目的 分析个案护理管理模式对社区COPD患者自我护理能力和健康行为的影响.方法 采用以社区居委会为单位的整群随机化分组,将两个居委会随机分为采取个案护理管理模式的研究组（32例）和社区慢性病常规护理的对照组（35例）.研究组接受为期1年的个案护理管理.两组患者以自我护理能力测定量表（ESCA）和健康促进生活方式量表（HPLP）,评价干预前后两组患者的自我护理能力及健康行为改善情况.结果 干预1年后,研究组的健康知识水平、自我责任感、自我护理技能及自我护理能力总分均明显高于干预前,差异有统计学意义（P＜0.05）.在基线阶段,对照组及研究组在各维度得分差异无统计学意义（P＞0.05）,而干预后,研究组在除自我概念外各维度得分均明显高于对照组,两组比较差异有统计学意义（t分别为-3.49,-5.78,-11.39,-7.54;P ＜0.01）.干预1年后,研究组的HPLP总分及6个维度得分均明显高于对照组,两组比较差异有统计学意义（t分别为-2.93,-2.32,-3.07,-4.47,-9.22,-5.63,-14.53;P＜0.05）.且干预后,研究组的各维度得分均明显高于干预前,差异有统计学意义（P＜0.05）.结论 运用个案护理管理模式能明显促进社区COPD患者的自我护理能力和行为,从而提升患者自我管理能力,是社区优质护理实施的有效方法.
Objective To analyze the effects of nurse-led case management on the self-care and health behaviors of the patients with chronic obstructive pulmonary disease （COPD） in community health service.Methods The groups were randomly divided based on the unit of community.According to the sampling results,a total of 67 patients participated in and completed the study,including the study group with 32 patients using the nurse-led case management nursing care,and the control group with 35 patients using conventional nursing method.The self-care agency scale （ESCA） and health promoting lifestyle profile （HPLP） were used to evaluate the changes of patients＇ self-care and health behaviors.Results After one-year intervention,the scores of health knowledge,self-responsibihty,self-care skills and self-care in the study group were significantly higher than those scores before intervention （P 〈 0.05）.At baseline,the scores of the patients in the control group and in the study group had no significant difference （P 〉 0.05）.But after the intervention,the scores,except for the aspect of self-concept,in the study group were significantly higher than those in the control group （t =-3.49,-5.78,-11.39,-7.54,respectively; P 〈 0.01）.After one-year intervention,the total scores and the scores of each dimensions of HPLP in the study group were significantly higher than the scores in the control group （t=-2.93,-2.32,-3.07,-4.47,-9.22,-5.63,-14.53,respectively; P〈0.05）.In addition,the scores in each dimension of the study group were significantly higher than the scores before the intervention （P 〈 0.05）.Conclusions The nurse-led case management can significantly promote the self-care ability and the health behaviors of the patients with COPD in community health service,so as to enhance their self-management skills.It is an effective way to implement quality community nursing.
出处
《中华现代护理杂志》
2014年第13期1510-1513,共4页
Chinese Journal of Modern Nursing
基金
2012年徐汇区医学科研基金立项（SHXH201240）
关键词
个案管理
护理
肺疾病
慢性阻塞性
自我管理
Case management
Nursing
Pulmonary diseases,chronic obstructive
Self-management
