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症状管理方案对慢性阻塞性肺疾病老年患者部分健康结果的影响:一项准实验研究。

Effects of symptom management program on selected health outcomes among older people with chronic obstructive pulmonary disease: a quasi-experimental study.

机构信息

Nong Wua So Hospital, Nong Wua So, Udon Thani Province, Thailand.

Department of Gerontological Nursing, Faculty of Nursing, Khon Kaen University, Khon Kaen, Thailand.

出版信息

Sci Rep. 2023 Dec 14;13(1):22265. doi: 10.1038/s41598-023-49654-5.

Abstract

Older adults have limitations from their aging process and chronic disease, so developed interventions must pay attention and concern to their aging degeneration and needs. This study aims to study the effects of a symptom management program on selected health outcomes among older people with chronic obstructive pulmonary disease. The quasi-experimental research included the 15 older patients in the control group receiving routine nursing care, while the other 15 in the experimental group received a 4-week symptom management program. First, the general information was analyzed using descriptive statistics. Next, the average health outcomes were analyzed using independent and dependent t-tests, Mann-Whitney U Test, and Wilcoxon Signed Ranks Test. In addition, the readmission rate was compared using Fisher's Exact Test. Results revealed that most of the older patients were men (96.7%), aged 60-88 years (Mean = 71.57, SD = 7.75), with a smoking history (93.3%). The improvements were found in dyspnea (p < .01), its severity during activities (p < .01), and the quality of life (p = .04) among patients who attended the program. However, both groups did not have a different pulmonary function (p = .25) and the proportion of readmission within 28 days (p = .50). This study shows that the symptom management program can reduce dyspnea and severity during activities and improve the quality of life. Older people suffer from chronic obstructive pulmonary disease, especially when experiencing dyspnea. Therefore, it is crucial to have a symptom management program for older patients, especially a program developed to respond to changes in the aging process and the limitations of older people. This developed program was age-friendly to deal with symptoms and improve quality of life. However, this program should be explored in typical situations without the effects of the coronavirus disease (COVID-19) pandemic. In addition, more extensive population-based studies and randomized controlled trials should be adopted to increase credibility and ensure generalization.Clinical Trial Registration Number: https://osf.io/6sj7y (October 4, 2021).

摘要

老年人由于衰老过程和慢性疾病而存在局限性,因此开发的干预措施必须关注和关心他们的衰老退化和需求。本研究旨在研究症状管理计划对慢性阻塞性肺疾病老年患者选定健康结果的影响。这项准实验研究包括对照组的 15 名老年患者,他们接受常规护理,而实验组的 15 名患者接受了为期 4 周的症状管理计划。首先,使用描述性统计分析一般信息。接下来,使用独立和依赖 t 检验、Mann-Whitney U 检验和 Wilcoxon 符号秩检验分析平均健康结果。此外,使用 Fisher 精确检验比较再入院率。结果表明,大多数老年患者为男性(96.7%),年龄在 60-88 岁(平均=71.57,SD=7.75),有吸烟史(93.3%)。参加该计划的患者呼吸困难(p<.01)、活动时的严重程度(p<.01)和生活质量(p=.04)均有所改善。然而,两组的肺功能(p=.25)和 28 天内再入院的比例(p=.50)均无差异。这项研究表明,症状管理计划可以减轻呼吸困难和活动时的严重程度,提高生活质量。患有慢性阻塞性肺疾病的老年人,尤其是出现呼吸困难时,更需要症状管理计划。因此,为老年患者制定症状管理计划非常重要,特别是制定针对老年人衰老过程和局限性变化的计划。该计划对年龄友好,可以处理症状并提高生活质量。然而,应该在没有冠状病毒病(COVID-19)大流行影响的典型情况下探索该计划。此外,应该采用更广泛的基于人群的研究和随机对照试验,以提高可信度并确保推广。临床试验注册号:https://osf.io/6sj7y(2021 年 10 月 4 日)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af71/10721618/61d981471039/41598_2023_49654_Fig1_HTML.jpg

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