Study Of Intervention Effect On Continuous Care Model To The Quality Of Life Of Chronic Obstructive Pulmonary Disease

ObjectiveTo establish hospital-community continuous nursing model on the basis of nurses and explore continuous care intervention model for the quality of life of chronic obstructive pulmonary disease.MethodsFrom November 2007 to October 2008,130 recruitments who were treated on admission because of chronic obstructive pulmonary disease were analyzed. The researcher divided the recruitments into intervention group and control group randomly. The number was 62 and 68. Interventions were applied for continuous nursing intervention model, including health education on COPD before discharge, giving COPD brochure, telephone follow-up to answer the questions which the patients need to solve once two weeks, home follow-up at one, three, six, twelve months post-hospital discharge for keeping on intervention. In the meantime, researcher established electronic health records (EHR), so as to know the development of own disease directly for patients and their relatives. Controls were given conventional care. Investigator who was trained together collected lung function, SGRQ scores, dyspnea degree, six minutes walk test, BMI which evaluated quality of life at before intervention, one-month, three-month, six-month, twelve month after intervention. T test, chi-square test and repeated analysis were performed throughout the research.Results1. Continuous nursing intervention model made a certain impact on FVC%(F=5.509, P<0.01), PEF (F=12.486, P<0.01), MEF25%FVC (F=2.861, P<0.05), MMEF (F=3.180, P<0.05), total score of quality of life (F=20.364, P<0.05),symptom score (F=16.194, P<0.05), influence score (F=3.729, P<0.05), dyspnea degree (F=36.306, P<0.05,6MWT (F=13.103, P<0.05),but FEV1%(F=2.324,P> 0.05), MEF75%FVC (F=2.397, P>0.05), MEF50%FVC (F=1.809, P>0.05), BMI (F=0.965, P>0.05) had no statistical significant on post-discharge.2. FEV1%, FVC% and activity scores of SGRQ between two groups had statistical significance in three-month after intervention (P<0.01). PEF, total scores of SGRQ, symptom scores, effect scores of SGRQ and dyspnea degree between two groups had statistical significance in one-month after intervention (P<0.01). Six minutes walk test between two groups had statistical significance in six-month after intervention (P <0.01). MMEF75-25% had statistical significance in twelve-month after intervention (P<0.01).The number of times of acute exacerbation in one year between two groups had statistical significance (P<0.05)3. One-month recurrent rate was 9.1%, three-month was 18.2%, six-month was 47.3%, twelve-month was 90.9% in the intervention group; one-month was 6.2%, three-month was 29.6%, six-month was 66.7%, twelve-month was 97.5% in control group. Compare two groups, the difference in six-month had statistical significant (P <0.05)Conclusion1. Although continuous nursing intervention model can not change the trend of lung function declining gradually, it will improve the quality of life and the dyspnea degree, decrease the recurrent frequency in one year, prolong recurrent time.2. The development and applicant of electronic health record achieves dynamic management of data and follow-up analysis, and make nursing records and other check report in hospital and community carry out operation on internet, information sharing, and providing instrument for networking referral.