Altern Ther Health Med. 2024 Sep;30(9):406-414.
The objective of this study is to propose and assess the clinical application value of a nursing intervention method based on the Integrated Theory of Health Behavior Change, aiming to address the increasing incidence and mortality of chronic obstructive pulmonary disease (COPD) and enhance the focus on its treatment and nursing in clinical practice.
The study included 120 COPD patients admitted to the respiratory department, using random number table method randomly assigned to a control group (Ctrl group, receiving routine nursing management) and an observation group (Obs group, receiving Integrated Theory of Health Behavior Change (ITHBC)-based nursing management), each comprising 60 cases. Self-management, recovery of lung function and clinical symptoms, and quality of life (QOL) of patients were compared in two groups.
In summary, the study demonstrated significant improvements in specific parameters among COPD patients receiving Integrated Theory of Health Behavior Change (ITHBC)-based nursing management compared to routine nursing management. After 2 months of intervention, the COPD self-management scale scores indicated noteworthy enhancements in symptom management (Obs: 29.12±4.01 vs. Ctrl: 26.53±3.66), daily living management (Obs: 53.77±4.78 vs. Ctrl: 45.21±4.02), emotional management (Obs: 46.56±5.83 vs. Ctrl: 34.10±4.83), information management (Obs: 29.83±5.33 vs. Ctrl: 25.37±5.83), self-efficacy (Obs: 34.32±4.78 vs. Ctrl: 28.38±3.33), and overall self-management (Obs: 184.18±24.03 vs. Ctrl: 170.88±22.66), all with statistical significance (P < .05). The 6-minute walk test (6MWT) demonstrated improved exercise endurance for the observation group after 1 and 4 months of intervention, with scores (380.03±52.47) significantly higher than the control group (351.73±51.26) at T3 (P < .05). Dyspnea scores were notably lower in the observation group, indicating reduced respiratory severity, and the comprehensive evaluation using the CAT scale showed significantly lower symptom scores in the observation group (Obs: 15.57±4.21 vs. Ctrl: 19.25±4.63) (P < .05). Finally, the WHOQOL-BREF scores reflected a higher quality of life for patients receiving ITHBC-based nursing management (Obs: P < .05), highlighting the substantial impact of ITHBC-based interventions in significantly enhancing self-management, lung function, exercise endurance, dyspnea, symptom recovery, and overall quality of life in COPD patients compared to routine nursing management.
In conclusion, the study underscores the effectiveness of Integrated Theory of Health Behavior Change (ITHBC)-based nursing management in significantly improving the self-management capabilities of COPD patients, leading to enhanced prognosis. The findings suggest that ITHBC holds promise as a valuable approach in nursing management for COPD and potentially extends its applicability to other chronic conditions. This study not only contributes to the understanding of effective interventions for COPD but also opens avenues for broader applications of ITHBC-based nursing management in the context of various chronic health conditions.
本研究旨在提出并评估一种基于健康行为改变综合理论的护理干预方法的临床应用价值，以应对慢性阻塞性肺疾病（COPD）发病率和死亡率的上升，并加强临床实践中对其治疗和护理的重视。
本研究纳入了 120 例呼吸科收治的 COPD 患者，采用随机数字表法将其随机分为对照组（Ctrl 组，接受常规护理管理）和观察组（Obs 组，接受基于综合健康行为改变理论（ITHBC）的护理管理），每组 60 例。比较两组患者的自我管理、肺功能和临床症状恢复以及生活质量（QOL）。
综上所述，与常规护理管理相比，接受基于综合健康行为改变理论（ITHBC）的护理管理的 COPD 患者在特定参数方面有显著改善。干预 2 个月后，COPD 自我管理量表评分显示症状管理（Obs：29.12±4.01 vs. Ctrl：26.53±3.66）、日常生活管理（Obs：53.77±4.78 vs. Ctrl：45.21±4.02）、情绪管理（Obs：46.56±5.83 vs. Ctrl：34.10±4.83）、信息管理（Obs：29.83±5.33 vs. Ctrl：25.37±5.83）、自我效能（Obs：34.32±4.78 vs. Ctrl：28.38±3.33）和整体自我管理（Obs：184.18±24.03 vs. Ctrl：170.88±22.66）均有显著提高，差异均有统计学意义（P<0.05）。观察组在干预 1 个月和 4 个月后 6 分钟步行试验（6MWT）的运动耐力均有改善，第 3 次随访（T3）时的评分（380.03±52.47）显著高于对照组（351.73±51.26）（P<0.05）。观察组呼吸困难评分明显降低，提示呼吸严重程度减轻，CAT 量表综合评价显示观察组症状评分显著降低（Obs：15.57±4.21 vs. Ctrl：19.25±4.63）（P<0.05）。最后，WHOQOL-BREF 评分反映了接受 ITHBC 护理管理的患者生活质量更高（Obs：P<0.05），这表明 ITHBC 干预在显著提高 COPD 患者自我管理能力、改善肺功能、增强运动耐力、减轻呼吸困难、改善症状恢复和整体生活质量方面具有显著作用，优于常规护理管理。
综上所述，本研究强调了基于健康行为改变综合理论（ITHBC）的护理管理在显著改善 COPD 患者自我管理能力方面的有效性，从而改善预后。研究结果表明，ITHBC 有望成为 COPD 护理管理的一种有价值的方法，并可能将其应用扩展到其他慢性疾病。本研究不仅有助于理解 COPD 的有效干预措施，还为基于 ITHBC 的护理管理在各种慢性健康状况下的更广泛应用开辟了途径。
