Application Of Pulmonary Rehabilitation Training Based On 5A Model For Elderly Patients With COPD

ObjectiveTo explore the effects of pulmonary rehabilitation based on 5A model to cognition,self-efficacy,compliance and the quality of life in elderly patients with chronic obstructive pulmonary diseases.So as to provide the reference basis and implementation plan of developing and improving the pulmonary rehabilitation program.Methods1.This study was a quasi experimental study.94 patients with COPD admitted to the department of respiratory medicine of a hospital in Changsha city in accordance with the inclusion criteria from June 2017 to January 2018 were randomly selected.94 patients who met the inclusion criteria randomly allocated to the intervention group and the control group,with 47 patients in each group.2.The intervention group accepted pulmonary rehabilitation program based on 5A model,the control group accepted routine respiratory care.Three questionnaires,including knowledge questionnaire,COPD self-efficacy questionnaire,the COPD comprehensive assessment questionnaire,and the BODE index after 3 months,6 months intervention were used to evaluate the outcomes of the intervention.All data were analyzed by the following statistical methods such as the Description Analyze,T-test,Rank test,the Chi-square Test with SPSS20.0.Result1.A total of 87 patients completed the study,44 in the intervention group and 43 in the control group.There was no significant difference in the general data between the two groups(P>0.05),which was comparable.2.There was no significant difference in the disease related knowledge scores between the two groups before intervention(P>0.05).At the end of 3 months after intervention,the disease related knowledge scores of the two groups were higher than those before the intervention,and the scores of the intervention group(26.27±4.11)were higher than the control group(23.72±2.78),the difference was statistically significant(P<0.05).At the end of 6 months after intervention,the scores of the intervention group(29.14±4.37)were higher than the control group(23.21±2.51),the difference was statistically significant(P<0.05).Repeated measures ANOVA revealed significant time effect,group main effect and interactions effect on the disease related knowledge scores.3.There was no significant difference in the total scores and dimensions of self-efficacy between the two groups before intervention(P>0.05).At the end of 3 months after intervention,the total scores of self-efficacy of the intervention group(101.93±9.00)were higher than that of the control group(88.98±10.17),and the scores of the two groups were statistically significant(P<0.05).At the end of 6 months after intervention,the total self-efficacy scores of the intervention group(104.30±12.95)were higher than that of the control group(85.12±12.75),and the scores of the two groups were statistically significant(P<0.05).Repeated measures ANOVA revealed significant time effect,group main effect and interactions effect on total scores of self-efficacy and dimensions(P<0.05).4.There was no significant difference in pulmonary rehabilitation compliance between the two groups before intervention(P>0.05).At the end of 3 months and 6 months after intervention,the pulmonary rehabilitation compliance of the intervention group was better than that of the control group,and the difference were statistically significant(P<0.05).5.There was no significant difference both the scores of CAT total scores and the scores of each item in the two groups before intervention(P>0.05).At the end of 3 months after intervention,the CAT total scores of the intervention group(17.34±3.01)was lower than those of the control group(19.77±3.90),and the differences were also statistically significant in cough,chest tightness,mobility and daily living ability(P<0.05).At the end of 6 months after intervention,except for sleep,the CAT total scores and the scores of each item in the two groups were statistically significant(P<0.05).Repeated measures ANOVA revealed significant time effect,group main effect and interactions effect on the CAT total scores(P<0.05).6.There were no significant differences in BMI,FEV1%/Pre,mMRC and 6MWD between the two groups before intervention(P>0.05).At the end of 3 months after intervention,the mMRC scores in the intervention group were lower than that in the control group,and the 6MWD in the intervention group(327.61±21.71)were higher than that in the control group(303.16±19.97),the difference was statistically significant(P<0.05);At the end of 6 months after intervention,the mMRC scores in the intervention group were lower than that in the control group,and the 6MWD in the intervention group(333.57±21.74)were higher than the control group(304.70±19.83),the difference was statistically significant(P<0.05).Repeated measures ANOVA revealed significant time effect,group main effect and interactions effect on the 6MWD(P<0.05).Conclusions1.The pulmonary rehabilitation training based on the 5A model can improve the disease related cognition level and self-efficacy of elderly COPD patients,and it has a certain positive effect on the patient’s pulmonary rehabilitation compliance.2.The pulmonary rehabilitation training based on the 5A model can reduce the degree of dyspnea,improve exercise tolerance and quality of life.