Li Meihua, Chang Yuyang, Fan Jia, Liang Bing, Qu Danhua
School of Nursing, Jilin University, Changchun, 130021, Jilin, China.
The Second Hospital of Jilin University, Changchun, 130022, Jilin, China.
BMC Nurs. 2025 May 26;24(1):591. doi: 10.1186/s12912-025-03213-7.
Pulmonary rehabilitation (PR) is essential for treating interstitial lung disease (ILD). The 5A nursing model enhances patients' health-promoting behaviors by improving their self-management skills. The aim of this study is to examine and analyze the effectiveness of the PR program based on the 5A nursing model concerning lung function, dyspnea, anxiety, depression, self-efficacy, quality of life, and PR compliance in patients with ILD.
64 hospitalized ILD patients were enrolled in this quasi-experimental study. Patients were randomly assigned to an intervention group (PR program based on the 5A nursing model) and a control group (conventional PR) on a ward-by-ward basis. The allocation was not concealed from the patients. A pre- and post-test design was used. An exercise training diary was utilized to evaluate PR compliance, data was gathered using the mMRC, HADS, PRAISE, and SGRQ, and lung function was assessed by a professional PR-trained nurse. SPSS 26.0 was used to analyze the data. For within/between-groups comparisons, the Wilcoxon signed-rank test, Fisher's exact test, t-test, χ²-test, and Mann-Whitney U-test were employed.
Baseline demographics were generally similar between the two groups (P > 0.05). After 10 weeks of intervention, the PR program based on the 5A nursing model group had more significant improvements in self-efficacy (P = 0.001), anxiety (P = 0.005), and depression (P = 0.018) compared to the control group, but there were no significant differences in dyspnea, lung function, or quality of life (P > 0.05). PR compliance was significantly higher in the intervention group than in the control group (P = 0.028). Further within-group comparisons showed significant improvements in DLCO%pred (P = 0.003), dyspnea (P = 0.001), anxiety (P = 0.006), self-efficacy (P < 0.001), and quality of life (P < 0.001) at post-test in patients in the intervention group compared to pre-test.
The PR program based on the 5A nursing model is an effective way to reduce anxiety, depression, and improve self-efficacy and PR compliance in patients with ILD.
Retroactive registration is underway on the Chinese Clinical Trial Registry (ChiCTR).
肺康复（PR）对于间质性肺疾病（ILD）的治疗至关重要。5A护理模式通过提高患者的自我管理技能来增强其健康促进行为。本研究的目的是检验和分析基于5A护理模式的PR方案在ILD患者的肺功能、呼吸困难、焦虑、抑郁、自我效能、生活质量和PR依从性方面的有效性。
64例住院的ILD患者参与了这项准实验研究。患者在逐个病房的基础上被随机分配到干预组（基于5A护理模式的PR方案）和对照组（传统PR）。分配情况未对患者隐瞒。采用前后测试设计。使用运动训练日记评估PR依从性，使用改良英国医学研究委员会呼吸问卷（mMRC）、医院焦虑抑郁量表（HADS）、肺康复自我效能量表（PRAISE）和圣乔治呼吸问卷（SGRQ）收集数据，肺功能由经过专业PR培训的护士进行评估。使用SPSS 26.0分析数据。对于组内/组间比较，采用威尔科克森符号秩检验、费舍尔精确检验、t检验、χ²检验和曼-惠特尼U检验。
两组的基线人口统计学特征总体相似（P > 0.05）。干预10周后，与对照组相比，基于5A护理模式的PR方案组在自我效能（P = 0.001）、焦虑（P = 0.005）和抑郁（P = 0.018）方面有更显著的改善，但在呼吸困难、肺功能或生活质量方面无显著差异（P > 0.05）。干预组的PR依从性显著高于对照组（P = 0.028）。进一步的组内比较显示，与干预前相比，干预组患者在测试后一氧化碳弥散量占预计值百分比（DLCO%pred）（P = 0.003）、呼吸困难（P = 0.001）、焦虑（P = 0.006）、自我效能（P < 0.001）和生活质量（P < 0.001）方面有显著改善。
基于5A护理模式的PR方案是降低ILD患者焦虑、抑郁，提高自我效能和PR依从性的有效方法。
正在中国临床试验注册中心（ChiCTR）进行追溯注册。
