| BackgroundBronchial asthma (abbreviated asthma) is a common chronic airway inflammation diseases and one of the most common chronic diseases in the world. Seriousness of asthma concludes high incidence, wildly involvement, recurrent attacks and no complete cure. NIH Cardiopulmonary Blood Institute with WHO jointly initiated formulate Global Initiative for Asthma (GINA). Chinese Medical Association (CMS) put the prevention of asthma on an important position according to GINA and established "bronchial Asthma Guide ".Although asthma cannot be cured completely now, researches show that effective asthma management can usually achieve asthma control. A good cooperation between patients and medical staff is the primary measure to guide the patient to achieve effective asthma self-management.Continuing nursing is realizes to the asthma effective management important way. Therefore, this topic plans to asthma patient to carry out the community continuing nursing intervention service, and appraises its effect.This research proposed to develop the continuing nursing intervention services in community with eh participation of Rank Three hospital. That is, we will help community hospitals relying the technical advantages of the first affiliated hospital Guangzhou Medical college/Guangzhou Respiratory Disease Institute. Through involvement help, guidance way to carry out asthma prevention and cure measures of Rank Three hospital to community and family through positive continue nursing care intervention in order to reduce relapse rate and improve life quality of asthma patients.ObjectsUnder the guidance of the GINA program and our guide and OREM bronchial asthma self-care model for the theoretical guidance to patients, Implement continue nursing plan, Evaluates theirs effects for treatment and the control of asthma disease, provides the research material to the Rank Three hospital to development asthma disease’s prevention and treatment.MethodsThis topic including asthma patient health education demand investigation and the analysis, nursing staffs asthma extension nursing ability’s training and the effect appraisal, the community continuing nursing intervention’s implementation and the effect appraises three parts.1.investigation the requirement for health education and health knowledge of the asthma patients. Provides the basis for the continuing nursing plan in community.(1) objects:59 bronchial asthma patients aged 18-75years were tested from the in-patient and out-patient clinic of the First Affiliated Hospital of Guangzhou Medical College, Department of Respiratory Medicine (Guangzhou Institute of Respiratory Diseases) clinic. All cases are diagnosed according to "Bronchial Asthma Guide" diagnostic criteria developed by Chinese Medical Association and are willing to be investigated. (2)methods:Questionnaire and interview method are used.The contents of the questionnaire conclude:①cognitive knowledge of health education;②extent of demand for health information③extent of demand for the way of health education.2. To train the nursing staffs who participates in this research, and to enhance nursing staff’s ability to continue nursing. (1) object:Voluntary participation of 22 practice nurses were trained. They are four respiratory clinical nurses, two Community Work Division nursing managers,,and 16 community health service center nurses, aged 27 to 49 years, mean 36.46±5.54,5～31 years working experience.The percentages of nurses with baccalaureate degree, advanced diploma and technical secondary diploma are 27.3%,45.4%,27.3%. (2) methods.①Research project designs through the establishment of continue nursing of asthma and then identify training needs.②Through literature review, thoroughly tested, to determine the content and personnel training.③According to the conditions of teaching content and resources to identify training methods and teaching activities.④Training on the implementation of Training in the form of theoretical lectures, case studies, role play, visits with education, training and other operations. Skills emphasized itemized according to operating instructions and clearance operations to ensure the student assessment and guidance, the operation in patients with accuracy and consistency of operations.⑤Methods of assessing the effects:Self-examination papers, marking operation skills, ability to score the standard practice of health education on students to evaluate.In addition, survey participants were trained to understand the training achievements and training of the comments and suggestions.3. Through the formulation and implementation of asthma patient community continuing nursing plan, appraises its effect to asthma disease treatment and the control. (1) object:112 patients in the Department of Respiratory Medicine, First Affiliated Hospital of Guangzhou Medical College (Guangzhou Institute of Respiratory Diseases) were include. The subjects were randomly divided into experimental and control group,57 cases in experimental group and 55 cases in control group. (2) methods:The control group received routine care, experimental group received routine care, the acceptance of continue nursing program, that is,①3 days before discharge, nurses should develop discharge planning and communicate with nurses in community hospital sharing information of patients discharged from hospital clinics, and to guide the implementation plan in community. Complete the referral items on the same day.②After 90 days of discharge:to provide 2 home visits (1 week after discharge, and0-12 weeks); provide every 2 weeks,1 telephone follow-up; on-demand telephone or visit follow-up; hotline.③6 months after discharge were evaluated.Results1. Patients with bronchial asthma have certain health information storage but lack of deep-level health knowledge guidance; demand more educational content for solving practical problems; the way of face to face teaching and dissemination of relevant information is most popular.2.A1l 22 nurses who Participates in the train, passed the examination. Before and after training were statistically significant different in the performance. Post-training survey results showed:①They can correctly understand the importance of the continue nursing of asthma;②learned well on the prevention and treatment of asthma;③enhanced their theoretical knowledge and practical instruction ability, which are really help in future work to asthma;④Learning to continue nursing model of asthma, other diseases, rehabilitation interventions are helpful to the community.3. The community continuing nursing intervention can improve asthma symptom, improves asthma patient quality of life.①knowledge of health awareness, health behaviors rates were 81.1% and 75.7% in experimental group, higher than the control group which were respectively 62.7%,58.5%(P<0.01);②Quality of Life:Scores of the experimental group in the activities of limited avoiding irritants, asthma symptoms, psychological and emotional, stimulus response, fear of disease and quality of life were better than the control group (P<0.01)③Asthma Control:The experimental group is significantly increased than the control group.Conclusion1. The community continuing nursing intervention can improve asthma symptom, improves asthma patient quality of life. The community continuing nursing model is: This research proposed to develop the continuing nursing intervention services in community with eh participation of Rank Three hospital. That is, we will help 16 community hospitals relying the technical advantages of the first affiliated hospital Guangzhou Medical college/Guangzhou Respiratory Disease Institute. Through involvement help, guidance way to carry out asthma prevention and cure measures of Rank Three hospital to community and family through positive continue nursing care intervention in order to reduce relapse rate and improve life quality of asthma patients.2. The community congtinuing nursing intervention service including asthma patient health education demand investigation and the analysis, nursing staffs asthma continuing nursing ability’s training and the effect appraisal, the community extension nursing intervention’s implementation and the effect appraises three parts.3. Health care workers need to further strengthen the health education of bronchial asthma, attention to educational content and method combination.4. Practical training required knowledge, skills and attitudes:ability, knowledge, skills and attitudes as the core content of the three nurses in uniform is a true reflection of ability. Knowledge, skills and attitude training to be required for a particular practice (such as asthma, extended care). The training is very concerned about the attitude of training, the humane care, clinical thinking, communication and interpersonal skills into the teaching content, and inspired their intrinsic motivation and positive.5. the continuing nursing model is:the nursing staffs who passing the training to congtinu implement the intervention to the patient who has Being discharged from the hospital.The content mainly includes to appraisal and to transform of the home environment, the physiology, the psychology, and medical monitor and daily life activity instruction and so on. |
