Faculty of Nursing, Midwifery & Health University of Technology, Sydney, Australia.
J Adv Nurs. 2010 Apr;66(4):784-93. doi: 10.1111/j.1365-2648.2009.05238.x.
To describe self-management, symptom monitoring and the associated influences among older adults with chronic obstructive pulmonary disease.
Optimal self-management and monitoring of key symptoms in patients with chronic obstructive pulmonary disease reduces dyspnoea and preventable hospitalizations.
A prospective, descriptive survey design was used and data collected from patients with moderate severity chronic obstructive pulmonary disease during home interviews between April 2005 and June 2006. Predictors of self-management and symptom monitoring were determined by linear regression analyses.
Patients' (n = 78) mean age was 73.37 years (SD 7.52); 55.1% were male and 66.7% were married. Most (92.3%) had concurrent illnesses, and 48.7% had been admitted to hospital for chronic obstructive pulmonary disease in the past 6 months. Self-management was good to very good, with poorer self-management predicted by lower self-efficacy (beta = -0.21), a weaker sense of coherence (beta = -0.03), and no hospitalization in the past 6 months (beta = -05). Symptom monitoring was not ideal, with more than 20% of patients not monitoring any of the key symptoms. More frequent symptom monitoring occurred among participants who were married (beta = 5.14) and had more severe disease (beta = 0.79).
As self-management and symptom monitoring ensure better outcomes among patients with chronic obstructive pulmonary disease, health professionals should encourage these behaviours. Involving partners, promoting self-efficacy and understanding of sense of coherence are helpful in this process.
描述慢性阻塞性肺疾病老年患者的自我管理、症状监测及其相关影响。
优化慢性阻塞性肺疾病患者的自我管理和关键症状监测可减轻呼吸困难并预防住院。
采用前瞻性描述性调查设计，于 2005 年 4 月至 2006 年 6 月期间通过家庭访谈收集中度慢性阻塞性肺疾病患者的数据。通过线性回归分析确定自我管理和症状监测的预测因素。
患者（n=78）的平均年龄为 73.37 岁（SD=7.52）；55.1%为男性，66.7%已婚。大多数患者（92.3%）患有合并症，48.7%在过去 6 个月内因慢性阻塞性肺疾病住院。自我管理状况良好至非常好，自我效能较低（β=-0.21）、心理一致性较弱（β=-0.03）且过去 6 个月内无住院经历（β=-05）预测自我管理较差。症状监测不理想，超过 20%的患者未监测任何关键症状。婚姻状况较好（β=5.14）和疾病较严重（β=0.79）的患者更频繁地监测症状。
自我管理和症状监测可确保慢性阻塞性肺疾病患者获得更好的结果，因此医护人员应鼓励这些行为。在这个过程中，让伴侣参与、提高自我效能和对心理一致性的理解是有帮助的。
