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慢性阻塞性肺疾病患者的自我管理教育方案能否改善生活质量?

Can a self-management education program for patients with chronic obstructive pulmonary disease improve quality of life?

机构信息

Hôpital du Sacré-Coeur de Montreal, Montreal, Quebec.

出版信息

Can Respir J. 2011 Sep-Oct;18(5):e77-81. doi: 10.1155/2011/263574.

Abstract

OBJECTIVE

To assess the effects of a self-management program on health-related quality of life (HRQoL) and morbidity commonly associated with chronic obstructive pulmonary disease (COPD).

METHODS

A total of 57 outpatients with stable COPD received four weeks of self-management education, while 45 patients received usual care. Patients were evaluated at baseline, at three months and one year following the educational intervention. The primary outcome variable was HRQoL measured by the St George's Respiratory Questionnaire (SGRQ). The secondary outcome variables were number of emergency room visits and hospitalizations for exacerbation.

RESULTS

The intervention group's HRQoL improved significantly at three months (total score A = -5.0 [P = 0.006]) and 12 months (total score A = -6.7 [P < 0.001]), as evidenced by decreased scores on the SGRQ. In contrast, the SGRQ scores increased significantly in the control group at three months (total score A = +3.7 [P = 0.022]) and 12 months (total score A = +3.4 [P = 0.032]). Global impact appeared to be responsible for the change in the intervention group. Moreover, in the intervention group, the number of hospitalizations dropped from 0.7⁄person⁄year to 0.3⁄person⁄year (P = 0.017), and emergency room visits dropped from 1.1 person⁄year to 0.2⁄person⁄year (P = 0.002), while subjects in the control group did not experience any significant decreases in these parameters.

CONCLUSIONS

A planned education program improved HRQoL while decreasing the number of emergency room visits and hospitalizations in patients with stable COPD; this improvement persisted at 12 months.

摘要

目的

评估自我管理计划对与慢性阻塞性肺疾病(COPD)相关的健康相关生活质量(HRQoL)和发病率的影响。

方法

共 57 例稳定期 COPD 门诊患者接受四周自我管理教育,45 例患者接受常规护理。在教育干预后 3 个月和 1 年对患者进行评估。主要结局变量是使用圣乔治呼吸问卷(SGRQ)测量的 HRQoL。次要结局变量是急诊室就诊次数和因加重而住院的次数。

结果

干预组的 HRQoL 在 3 个月(总评分 A = -5.0 [P = 0.006])和 12 个月(总评分 A = -6.7 [P < 0.001])时显著改善,表现为 SGRQ 评分降低。相比之下,对照组在 3 个月(总评分 A = +3.7 [P = 0.022])和 12 个月(总评分 A = +3.4 [P = 0.032])时 SGRQ 评分显著增加。总体影响似乎是干预组变化的原因。此外,在干预组中,住院人数从 0.7 人/年降至 0.3 人/年(P = 0.017),急诊就诊人数从 1.1 人/年降至 0.2 人/年(P = 0.002),而对照组患者在这些参数方面没有任何显著减少。

结论

计划的教育计划改善了稳定期 COPD 患者的 HRQoL,同时减少了急诊室就诊次数和住院人数;这种改善在 12 个月时仍持续存在。

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