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IKAP教育模式在慢性阻塞性肺疾病患者症状群管理中的作用

The role of the IKAP education model in management of symptom clusters of patients with chronic obstructive pulmonary disease

    摘要
  • 摘要: 目的 探讨信息-知识-态度-行为教育模式在慢性阻塞性肺疾病（慢阻肺）患者症状群管理中的应用效果,分析其改善症状群的可行性。方法 便利选取2024年在中山大学附属第三医院呼吸与危重症医学科住院的慢阻肺患者为研究对象。采用前瞻性非同期研究设计,将2024年1至5月住院的63例患者设为对照组,将2024年8至12月住院的62例患者设为观察组。对照组接受常规健康教育和随访,观察组接受信息-知识-态度-行为教育模式的干预和随访,比较2组患者在干预后的慢阻肺疾病评估测试问卷（CAT）、改良版英国医学研究委员会呼吸困难问卷（mMRC）、圣乔治呼吸问卷（SGRQ）、汉密尔顿抑郁量表（HAMD-17）、汉密尔顿焦虑量表（HAMA）、慢性病管理自我效能量表（CDSES）、肺康复计划依从性调查表得分,以及血气分析结果中氧分压（PaO2）和二氧化碳分压（PaCO2）、血氧饱和度（SpO2）的差异。结果 干预前,2组患者的一般情况比较差异无统计学意义（均P > 0.05）。干预后,观察组的CAT为（12.87±4.74）分、mMRC为2.00（1.00,2.00）分、HAMD-17为（18.37±5.23）分、HAMA为3.00（2.00,4.25）分、SGRQ为20.15（11.70,29.85）分、PaCO2为（44.33±8.88）mmHg,均低于对照组的（20.14±8.02）分、2.00（1.00,3.00）分、（23.11±9.05）分、4.00（2.00,6.00）分、26.70（14.30,35.50）分、（51.57±12.88）mmHg（均P < 0.05）；观察组的PaO2为（84.64±15.47）mmHg、SpO2为（94.69±2.37）%、CDSES为（26.82±3.57）分、肺康复计划依从性为（21.82±2.43）分,均高于对照组的（72.92±13.10）mmHg、（92.32±2.47）%、（19.67±2.21）分和（14.97±2.01）分（均P < 0.05）。结论 IKAP教育模式的慢阻肺患者症状群管理,可提高患者自我管理能力及肺康复依从性,从而改善患者症状群、低氧血症和高碳酸血症,提高患者生活质量,为慢阻肺患者的长期管理提供了一种有效的健康教育策略。

     

    Abstract: Objective To explore the role of “Information-Knowledge-Attitude-Practice （IKAP）” education model in the management of symptom clusters of patients with chronic obstructive pulmonary disease （COPD）, and assess the feasibility of mitigating symptom clusters. Methods COPD patients admitted to Department of Pulmonary &; Critical Care Medicine of the Third Affiliated Hospital of Sun Yat-sen University in 2024 were recruited by convenience sampling. In this non-concurrent prospective study, 63 patients hospitalized from January to May 2024 were included in the control group and received regular health education and follow-up. 62 patients hospitalized from August to December 2024 were enrolled in the intervention group and received IKAP health education and follow-up. The improvement of symptom clusters was assessed by using COPD Assessment Test （CAT） and modified Medical Research Council Dyspnea Scores （mMRC）. The anxiety state of patients was evaluated by HAMD-17 and HAMA. The health status was assessed by using St. George’s Respiratory Questionnaire （SGRQ）. The treatment compliance was evaluated using Chronic Disease Self-Efficacy Scale （CDSES） and pulmonary rehabilitation program compliance questionnaire. The objective respiratory function was assessed by comparison of PaO2, PaCO2 and SpO2 before and after intervention. Results There were no significant differences in clinical characteristics between two groups （all P > 0.05） before treatment. After IKAP health education, the score of CAT was （12.87±4.74）, 2.00 （1.00,2.00） for mMRC, （18.37±5.23） for HAMD-17, 3.00 （2.00,4.25） for HAMA, 20.15 （11.70,29.85） for SGRQ and （44.33±8.88） mmHg for PaCO2 were significantly lower than （20.14±8.02）, 2.00 （1.00,3.00）, （23.11±9.05）, 4.00 （2.00,6.00）, 26.70 （14.30,35.50） and （51.57±12.88） mmHg in the control group, respectively （all P < 0.05）. In the intervention group, PaO2 was measured as （84.64±15.47） mmHg, SpO2 was （94.69±2.37）%, CDSES was （26.82±3.57） and pulmonary rehabilitation program compliance was （21.82±2.43）, significantly higher than （72.92±13.10） mmHg, （92.32±2.47）%, （19.67±2.21） and （14.97±2.01） in the control group, respectively （all P < 0.05）. Conclusions Application of IKAP education model in the management of symptom clusters of COPD patients could improve the quality of life by enhancing patients’ self-management ability and treatment compliance as well as reducing the events of hypoxemia and hypercapnia. IKAP model provides a beneficial health education strategy for long-term management of COPD patients.

     

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