| Objective:The purpose of this study is to understand the current situation and influencing factors of pulmonary rehabilitation management of patients with chronic obstructive pulmonary disease,construct a nursing intervention model based on the Behavior Change Wheel(BCW),explore in depth the practical effects of the intervention model based on the BCW theory,in the pulmonary rehabilitation management of patients with chronic obstructive pulmonary disease,on patients’ lung function,6min walking distance experiment,dyspnea degree,and quality of life,in order to promote patients’ behavior change,enhance patients’ belief in rehabilitation and self-efficacy,provide a new direction for clinical nurses’ pulmonary rehabilitation practice,and provide a theoretical basis for the role of behavior change theory in the health promotion of patients with chronic obstructive pulmonary disease.Methods: The study was a single-center,prospective randomized controlled study,using a convenience sampling method and SPSS22.0 software to generate random numbers for grouping.Patients who attended a tertiary care hospital in Anhui Province from June 2021 to June 2022 in the Department of Respiratory and Critical Care Medicine,were hospitalized for ≥7 days,had clear consciousness,normal communication,no motor dysfunction,and were assessed by clinicians and rehabilitation The patients were assessed by clinicians and rehabilitation therapists to be able to participate in this study,and those who voluntarily participated and could cooperate to complete the study were the subjects of this study.A total of 91 patients were randomly divided into control and experimental groups,45 patients in the experimental group and 46 patients in the control group,and each group implemented conventional treatment and care measures,but the control group implemented conventional pulmonary rehabilitation care measures and the experimental group implemented pulmonary rehabilitation care management measures based on BCW theory on the basis of the control group.The contents were divided into:individualized assessment,promotion of knowledge acquisition,strengthening of health beliefs,establishment of exercise behavior,social support,and also incorporation of the We Chat group as an aid to the establishment of exercise behavior at home for the patients into the nursing intervention program.The evaluation of intervention effects was performed using pulmonary function,exercise tolerance,degree of dyspnea,and quality of life,and data were collected on the day of admission,on the day of discharge,and at 1 month of discharge.SPSS22.0 was used to statistically analyze the data,and the statistical methods used in this study were: descriptive statistical analysis,chi-square test,rank sum test,and independent sample t-test.Results: 1.Shedding of study subjects during the intervention period: A total of 100 patients with COPD were included in the study,50 in the control group and 50 in the intervention group.During the study period,3 patients in the control group were transferred to hospital and 1 patient died at home during the intervention period,while 5 patients in the experimental group were discharged,4 were withdrawn automatically and 1 was transferred to hospital.2.Among the 91 patients enrolled in this study,the general data of the two groups were compared,and there were no statistically significant differences in the clinical data of the two groups in terms of age,gender,education,disease duration,disease classification,marital status,occupation,type of health insurance,primary caregiver,CAT score,m MRC score,and familiarity with knowledge related to pulmonary rehabilitation(P > 0.05).3.6min walking distance score of COPD patients: the difference between the scores of each dimension of the two groups before the intervention was not statistically significant(P>0.05);after the intervention,the scores of each dimension of the experimental group were higher than those of the control group,and the difference was statistically significant.(P﹤0.05)4.Comparison of m MRC score and CAT score: 3 days after the intervention,at the time of discharge and one month after discharge,the m MRC score and CAT score of the experimental group were lower than those of the control group,and the differences were statistically significant.There was no statistically significant difference between the total CAT score and the scores of each item in the two groups before the intervention(P>0.05);1 month after discharge,except for confidence in going out,sleep and energy,the total CAT score and the scores of each item in the intervention group were lower than those in the control group,and the difference was statistically significant(P<0.05);1 month after discharge,except for sleep,the total score and the scores of each item in the intervention group were lower than those in the control group.The difference was statistically significant(P<0.05).5.the differences in pulmonary function(FEV1/FVC,FEV1%pred)between the two groups before the intervention were not statistically significant(P>0.05).One month after discharge,the lung function scores of patients in the intervention group were higher than those of the control group during the same period,and the difference was statistically significant(P<0.05).6.When comparing the total number of days patients were hospitalized in the respiratory and critical care medicine unit,the total length of stay of patients was compared to[22.50,(15.75,31.5)] days in the test group and [24,(16,28.5)] days in the control group,with no statistically significant difference(P > 0.05).Conclusion: The exercise care intervention program for pulmonary rehabilitation of COPD patients based on BCW theory can help patients establish exercise behaviors that can improve their lung function,exercise tolerance,improve their dyspnea,and improve their quality of life. |
PDF Full Text Request