| Objective:To construct an evidence-based COPD self-management intervention(SMI)program for stable elderly patients,and to explore the application and effect evaluation of evidence-based practice program.Methods:First part,based on the concept of evidence-based intervention plan preliminary construction.COPD self-management intervention status both at home and abroad,search for relevant evidence of COPD self-management intervention,using something into the guide and literature Ⅱ and JBI quality evaluation standards to guide and included in the literature to carry out the quality evaluation,respectively,on the basis of JBI recommendation system of evidence,recommendations were given.Stakeholders were organized to make professional judgments,and focus group interviews were conducted among experts in different disciplines by means of the idea sampling method.The feasibility of the implementation of the plan was discussed from the perspectives of different disciplines and stakeholders,and the preliminary plan was revised to finally determine the content of the evidence-based practice plan.Second part,Experimental Study.A total of 102 COPD patients who attended the First and Second Affiliated Hospitals of Bengbu Medical College from September to December 2019 were included as the research subjects,and they were randomly divided into two groups.The control group was given routine nursing instruction,and the experimental group was given the implementation of self-management intervention program for COPD in stable elderly.Patients in the control group were given routine nursing guidance,and patients in the experimental group were given COPD self-management intervention program in the stable period of the elderly.Lung function indicators(FEV1/FVC,FEV1%),BODE index,Chronic Obstructive Lung Disease Quality of Life Scale(CAT),Fatigue Scale(FS-14)and health service utilization were used to evaluate patients in the two groups before and 6 months after intervention respectively,and the differences in observation indicators between the two groups were compared.Results:1.Older plateau evidence-based practice: COPD patients include giving evidence to recommend entry summary of evidence,and the effectiveness of the proposed scheme in,implementation time,place,implementation team,implementation mode,implementation principle,the implementation of target,evaluate the timing and content,COPD self-management intervention content,quality control and effect evaluation in 11,recommend entry form of 24.2.In the application of evidence-based practice scheme,the effect of the experimental group and the control group was evaluated.The results showed that before intervention,the baseline data of patients in the experimental group and the control group were comparable,and the differences were not statistically significant(P>0.05).After 6 months of intervention,the lung function level of the experimental group was significantly better than that of the control group(P< 0.05),the BODE scores were better than those of the control group(P<0.05),the CAT scores were better than those of the control group(P<0.05),FS-14 score were significantly lower than the control group,with statistical differences(P < 0.05),the use of health services(number of readmissions and number of acute exacerbations)in the control group was lower than that in the experimental group,with statistical differences(P<0.05).Conclusion:1.The evidence-based practice plan for self-management of COPD in stable elderly patients is based on the best evidence integration,combined with the current clinical actual situation,patient wishes and expert judgments at relevant levels,and can provide evidence-based practice basis for clinical care.2.The evidence-based practice program of self-management intervention for COPD in stable elderly patients can effectively improve the level of pulmonary function,reduce the severity of the disease,improve patients’ quality of life and fatigue degree,reduce the number of readmissions and acute exacerbations. |
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