| ObjectiveThrough the transitional care of COPD patients with type Ⅱ respiratory failure after ICU,to alleviate the physiological and psychological barriers and to improve the quality of life of patients.To investigate the clinical effect of transitional care model on intervention of post-intensive care syndrome in COPD patients with type Ⅱ respiratory failure.Methods70 patients with COPD combined with type Ⅱ respiratory failure who were treated by ICU into the respiratory ward for sequential therapy in a Third Grade & First-class hospital in Qingdao from February 2016 to July 2016 were selected.The subjects were informed and signed the consent form;patients were screened by the investigators according to the inclusion and exclusion criteria.They were divided into the testing group and the control group after pairing,with 34 cases in the control group and 36 cases in the testing group.Patients and their families from the control group received nursing and health guidance before discharged as in a conventional nursing mode,and patient’s condition as well as drug use were taken over with the ward nurses.On the basis of the nursing care received in the control group,the testing group was given nursing intervention by the transitional nursing group.The improvement of PICS in the two groups was compared,including the incidence of adverse events,rate of return to ICU,mortality,hospitalization days after ICU,anxiety/depression and blood gas analysis(PH,Pa O2,Pa CO2).ResultsThere were 66 patients who completed the study.In the control group,31 patients completed the study,and there were 3 patients who did not complete the project.In thetesting group,35 patients completed the study,and there were 1 patients who did not complete the project.1 General data comparisonThere was no significant difference between the two groups in general social data and indicators of lung function before transferred to other departments.(P > 0.05).2 Comparison of hospital anxiety and depression scores(1)Comparison of scores of Anxiety Depression Scale within the two groups: the anxiety score(t=9.672,P<0.05)and the depression score(t=6.986,P<0.05)in the testing group after intervention were statistically significant compared with those before the intervention;result of the anxiety score(t=6.220,P<0.05)in the control group was the same as the testing group,while the difference of the depression score(t=3.649,P<0.05)was statistically significant.(2)Comparison of scores of Anxiety Depression Scale between the two groups:there was a significant difference of the anxiety score(t=2.313,P<0.05)between the testing group and the control group after intervention;there was a significant difference of the depression score(t=2.965,P<0.05)between the testing group and the control group.3 Comparison of laboratory test indexes(1)Comparison of blood gas analysis indexes within the two groups: there were significant differences of PH(t=9.466,P<0.05),Pa O2(t=3.546,P<0.05),Pa CO2(t=4.663,P<0.05)in the testing group after the intervention;the results of PH(t=5.568,P<0.05)、Pa O2(t=2.016,P<0.05)、Pa CO2(t=2.989,P<0.05)in the control group were the same as the testing group,the differences were statistically significant.(2)After the intervention,there were significant differences of the blood gas analysis indexes of PH(t=2.703,P<0.05)、Pa O2(t=2.077,P<0.05)、Pa CO2(t=2.199,P<0.05)in the testing group compared with those in the control group.4 Comparison of sensitive quality indexes(1)Comparison of the incidence of adverse events and the hospitalization days after ICU between the two groups: there were significant differences of the incidence of adverse events(c2=4.022,P<0.05)and hospitalization days after ICU(t=6.942,P<0.05)after intervention in the testing group compared with those of the control group.(2)Comparison of the rate of return to ICU and mortality between two groups: there were no significant differences of the rate of return to ICU(c 2=0.012,P>0.05)andmortality(P>0.05)after the intervention in the testing group compared with those of the control group.ConclusionsThis study suggested that the transitional care model after ICU had a significant effect on COPD patients with type Ⅱ respiratory failure in improving depression and anxiety and the state of mental disorders.The transitional care model after ICU could also improve the blood gas analysis(PH,Pa O2,Pa CO2)as well as other laboratory test indicators to enhance the pulmonary respiratory function.This kind of nursing model had a positive effect on reducing the incidence of adverse events after ICU and shortening the number of hospitalization days after ICU.However,the improvement in the rate of return to ICU and mortality in this study was poor.This kind of care model provided a clinical reference for improving the PICS in critically ill patients of respiratory system. |
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