合并慢性阻塞性肺疾病和慢性心力衰竭患者的个体化护理干预。
Individualized Nursing Interventions in Patients with Comorbid Chronic Obstructive Pulmonary Disease and Chronic Heart Failure.
出版信息
Altern Ther Health Med. 2023 Nov;29(8):329-333.
OBJECTIVE
Individuals with chronic obstructive pulmonary disease (COPD) are more likely to develop heart failure (HF) compared with the general population, and the presence of HF may contribute to reduced quality of life (QoL), increased hospitalizations and worse survival rates in patients with COPD. Our study examined the exercise capacity, QoL, mental health, family burden and rehospitalization rate of patients with comorbid COPD and chronic heart failure (CHF) after individualized inpatient and outpatient nursing care.
METHODS
A total of 100 patients with comorbid COPD and CHF admitted to Affiliated Hospital of Jiangnan University January 2021 to July 2022 were enrolled in our study and then randomly assigned to one of two groups of 50 patients: patients receiving traditional nursing care and patients receiving individualized nursing care. Exercise capacity, mental health, QoL and family burden were assessed by means of the 6-minute walk test (6MWT), Zung's Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS), the short-form health survey (SF-36) and the Perceived Family Burden Scale (PFBS).
RESULTS
The patients receiving individualized nursing care had notable differences regarding distance walked in the 6MWT, the scores in all domains of both the physical and mental composites, SAS and SDS scores and PFBS scores of patients at on admission (T0), at discharge (T1) and at 2 months after discharge (T2) (P < .05). The patients receiving individualized nursing care walked longer distances on the 6MWT, more scores reflecting improved QoL and reduced SAS and SDS scores at both T1 and T2 compared with patients receiving traditional nursing care (P < .05). The patients receiving individualized nursing care exhibited decreased PFBS scores at T2 compared with patients receiving traditional nursing care (P < .05). None of the patients receiving individualized nursing care were rehospitalized, but 2 patients receiving traditional nursing care were rehospitalized due to acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and acute HF, respectively.
CONCLUSION
Our study demonstrates that individualized inpatient and outpatient nursing care can enhance exercise capacity and improve QoL and mental health in patients with comorbid COPD and CHF.
目的
与普通人群相比，慢性阻塞性肺疾病（COPD）患者更易发生心力衰竭（HF），HF 的存在可能导致 COPD 患者生活质量（QoL）下降、住院次数增加和生存率降低。我们的研究考察了在接受个体化住院和门诊护理后，合并 COPD 和慢性心力衰竭（CHF）的患者的运动能力、QoL、心理健康、家庭负担和再住院率。
方法
2021 年 1 月至 2022 年 7 月，我们共纳入了 100 例在江南大学附属医院住院的合并 COPD 和 CHF 的患者，并将其随机分为两组，每组 50 例：接受传统护理的患者和接受个体化护理的患者。通过 6 分钟步行试验（6MWT）、Zung 焦虑自评量表（SAS）和抑郁自评量表（SDS）、健康调查简表（SF-36）和家庭负担感知量表（PFBS）评估患者的运动能力、心理健康、QoL 和家庭负担。
结果
接受个体化护理的患者在 6MWT 中步行的距离、身体和心理综合各领域的得分、SAS 和 SDS 评分以及入院时（T0）、出院时（T1）和出院后 2 个月（T2）的 PFBS 评分均有显著差异（P<0.05）。与接受传统护理的患者相比，接受个体化护理的患者在 T1 和 T2 时在 6MWT 中行走的距离更长，反映 QoL 改善的得分更多，SAS 和 SDS 评分更低（P<0.05）。与接受传统护理的患者相比，接受个体化护理的患者在 T2 时的 PFBS 评分更低（P<0.05）。接受个体化护理的患者均未再住院，但有 2 例接受传统护理的患者因慢性阻塞性肺疾病急性加重（AECOPD）和急性 HF 而再次住院。
结论
我们的研究表明，个体化住院和门诊护理可以提高合并 COPD 和 CHF 患者的运动能力，改善 QoL 和心理健康。
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