叙事护理对慢性阻塞性肺疾病患者呼吸困难信念的干预研究

张丹; 齐宏波; 安欣; 王秋爽; 史新慧; 马京华

doi:10.7619/jcmp.20222657

叙事护理对慢性阻塞性肺疾病患者呼吸困难信念的干预研究

Intervention of narrative nursing on breathlessness beliefs in chronic obstructive pulmonary disease patients

摘要

摘要:
目的探讨叙事护理在慢性阻塞性肺疾病(COPD)患者呼吸困难信念的应用效果。
方法选取确诊为急性期COPD的76例患者为研究对象, 采用随机数字表法将其分为叙事组和常规组，每组38例。常规组患者给予COPD常规护理，叙事组在常规护理基础上增加叙事护理干预。比较2组患者呼吸困难信念、出院准备度及运动依从性。
结果干预过程中, 8例患者脱落, 2组各失访4例。干预后, 2组患者呼吸困难信念问卷(BBQ)评分、恐惧呼吸困难维度(BBQ-SF)评分、恐惧活动维度(BBQ-AA)评分均较干预前降低，且叙事组患者以上评分低于常规组，差异有统计学意义(P < 0.05)。出院时，叙事组出院准备度量表评分为(88.39±6.28)分，高于常规组的(80.66±5.72)分，差异有统计学意义(P < 0.05)。
结论叙事护理可以降低急性期COPD患者的呼吸困难信念，提高出院准备度和稳定期COPD患者的运动依从性。

Abstract:
Objective To explore the effect of narrative nursing in chronic obstructive pulmonary disease (COPD) patients with breathlessness beliefs.
Methods A total of 76 patients diagnosed with acute stage COPD were selected as study objects, and were randomly divided into narrative group and routine group by random number table method, with 38 patients in each group. The routine group was given COPD routine nursing, and the narrative group was given narrative nursing intervention on the basis of routine nursing. Breathlessness beliefs, discharge readiness and exercise compliance were compared between the two groups.
Results During the intervention, eight patients were lost and four patients were lost during follow-up in each group. After intervention, the Breathlessness Beliefs Questionnaire (BBQ) score, Somatic Focus dimension (BBQ-SF) score and Activity Avoidance dimension (BBQ-AA) score were all lower than before intervention, and the above scores were lower in the narrative group than in the routine group (P < 0.05). At discharge, the readiness for discharge score was (88.39±6.28) in the narrative group, which was higher than (80.66±5.72) in the routine group (P < 0.05).
Conclusion Narrative nursing can reduce the breathlessness beliefs in patients with acute COPD, and improve discharge readiness and exercise compliance of stable stage COPD patients.

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