慢性阻塞性肺疾病患者家庭模式肺康复依从性变异曲线研究

翟文爽; 蔡汉炯; 钱佳; 郭利琴

doi:10.16766/j.cnki.issn.1674-4152.003073

慢性阻塞性肺疾病患者家庭模式肺康复依从性变异曲线研究

doi: 10.16766/j.cnki.issn.1674-4152.003073

1.
浙江中医药大学滨江学院附属江南医院呼吸科，浙江杭州 311201
2.
浙江中医药大学滨江学院附属江南医院急危重症科
3.
浙江中医药大学滨江学院附属江南医院护理部

基金项目:

浙江省医药卫生科技计划项目 2021KY271

详细信息

通讯作者:
郭利琴, E-mail：1850580415@qq.com

中图分类号: R563
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出版历程
- 收稿日期: 2022-11-28
- 网络出版日期: 2023-08-28

Study on the variability curve of family mode pulmonary rehabilitation compliance in patients with chronic obstructive pulmonary disease

1.
Department of Respiratory Medicine, Jiangnan Hospital Affiliated to Binjiang College of Zhejiang University of Traditional Chinese Medicine, Hangzhou, Zhejiang 311201, China

摘要

摘要: 目的研究慢性阻塞性肺疾病(COPD)患者家庭模式肺康复依从性的变化规律，寻找影响因素，明确干预节点。方法选取2021年1—12月在浙江省中医药大学附属江南医院呼吸或急危重症科住院治疗的COPD患者82例进行前瞻性观察研究，对纳入研究的对象给予住院期间填写康复手册、建立康复档案、教导肺康复的方法、开具肺康复处方。在患者出院0~12周期间，每隔2周进行电话或现场随访，根据“COPD患者肺功能锻炼依从性量表”记录每次随访的依从性水平分值。使用SPSS 25.0统计学软件分析数据，并用MATLAB 2020软件对数据进行拟合，绘制变异曲线，寻找依从性影响因素及变化时间节点。结果 COPD患者家庭模式肺康复依从性水平普遍较低，0~4周上升，4周以后逐渐下降，第4周依从性水平最高，平均值为(34.46±5.99)分。文化程度、年龄和医疗支付方式不同的患者依从性水平差异有统计学意义(P＜0.01)；多因素回归分析显示，医疗支付方式为主要影响患者依从性的因素。结论 COPD患者家庭模式肺康复的依从性水平普遍较低，依从性变异曲线随时间变化呈先升高后下降趋势。全医保支付，选择适合家庭模式肺康复呼吸功能锻炼的器具，并在依从性水平逐渐下降的时间节点即出院后4~6周停滞徘徊区予以正确的干预，有利于提高COPD患者家庭模式肺康复依从性。
- 慢性阻塞性肺病 /
- 肺康复 /
- 依从性 /
- 变异曲线
Abstract: Objective To study the variety rule of family mode pulmonary rehabilitation compliance in patients with chronic obstructive pulmonary disease (COPD), find influencing factors, and identify intervention nodes. Methods Eighty-two COPD patients who were hospitalized in the Department of Respiratory and Critical Care Medicine, Jiangnan Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine from January to December 2021 were selected as the research subjects, and a prospective observational study was conducted. For the patients included in the study, they filled out the rehabilitation manual during hospitalization, established rehabilitation files, teach pulmonary rehabilitation methods, and issued pulmonary rehabilitation prescriptions. During the 0-12 weeks after the patients were discharged from the hospital, telephone or on-site follow-up was conducted every 2 weeks, and the adherence level score of each follow-up was recorded according to the "COPD Patient Pulmonary Function Exercise Adherence Scale". SPSS 25.0 was used to analyze the date, and MATLAB 2020 software was used to fit the data, draw variation curves, and search for compliance influencing factors and change time nodes. Results The compliance level of COPD patients with family mode pulmonary rehabilitation was generally low, increased from 0 to 4 weeks, and gradually decreased after 4 weeks. The compliance level was the highest in the fourth week, with an average of (34.46±5.99) points. There were significant differences in the level of compliance of patients with different education levels, ages and medical payment methods (P<0.01). Multivariate regression analysis showed that medical payment methods were the main factors affecting patient compliance. Conclusion The compliance level of family mode pulmonary rehabilitation in COPD patients is generally low, and the compliance variation curve first increases and then decreases with time. Full medical insurance payment, choosing equipment suitable for family mode pulmonary rehabilitation and respiratory function exercise, and providing correct intervention in the stagnant and wandering area at the time when the compliance level gradually decreases in 4 to 6 weeks after discharge, are conducive to improving the family model of COPD patients rehabilitation compliance.
- Chronic obstructive pulmonary disease /
- Pulmonary rehabilitation /
- Compliance /
- Variation curve

HTML全文

图 1 慢性阻塞性肺疾病患者家庭模式0~12周肺康复依从性变异曲线

Figure 1. The variation curve of pulmonary rehabilitation compliance in patients with chronic obstructive pulmonary disease (COPD) from 0 to 12 weeks in family model

下载: 全尺寸图片幻灯片

表 1 82例慢性阻塞性肺疾病患者一般情况及依从性水平比较(x±s，分)

Table 1. Comparison of general conditions and compliance levels of 82 patients with chronic obstructive pulmonary disease (x±s, points)

项目	例数	依从性水平	统计量	P值
性别			1.376^a	0.173
男性	55	21.00±5.29
女性	27	19.26±5.58
文化程度			-3.636^a	0.001
文盲	30	17.50±6.23
非文盲	52	22.12±4.07
年龄(岁)			9.693^b	< 0.001
45~60	14	23.07±5.66
61~80	42	21.67±3.73
＞80	26	17.00±6.07
医疗支付方式			9.637^a	< 0.001
医保	73	21.29±5.08
自费	9	13.44±1.67
职业			-0.185^a	0.854
退休	48	20.33±5.49
农民	34	20.56±5.38
注：^a为t值，^b为F值。

下载: 导出CSV

表 2 慢性阻塞性肺疾病患者依从性水平影响因素的多元线性回归分析

Table 2. Multiple linear regression analysis of influencing factors of compliance level in patients with chronic obstructive pulmonary disease

变量	B	SE	β	t值	P值	95% CI
年龄	-1.471	1.022	-0.187	-1.440	0.154	-3.505~0.562
医疗支付方式	-5.233	1.907	-0.304	-2.745	0.008	-9.029~-1.437
文化程度	1.684	1.468	-0.151	1.147	0.225	-1.238~4.605

下载: 导出CSV

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