Influence Of Discharge Plan Based On Systematic Evaluation On Self-management And Quality Of Life Of Elderly Patients With Chronic Obstructive Pulmonary Disease

Objective To construct a discharge plan for elderly patients with chronic obstructive pulmonary disease(COPD)based on systematic evaluation,and to evaluate its impact on the self-management ability and quality of life of elderly patients with COPD,so as to provide a reference for elderly patients with COPD to develop comprehensive discharge plan services,and to improve the efficiency and quality of nursing services.Methods In this study,the discharge plan based on system evaluation was constructed,and the plan was revised according to the suggestions and pre experiments put forward by relevant experts.From March to June 2019,60 elderly patients with COPD who were hospitalized in the Department of respiratory and critical care medicine of General Hospital of Ningxia Medical University and met the inclusion exclusion criteria were selected as the study objects.According to the sequence of admission time,they were numbered and randomly divided into two groups by using random number table,30 in the intervention group and 30 in the control group.Patients in the control group were given routine discharge guidance,while patients in the intervention group were given discharge planning intervention based on systematic evaluation on the basis of routine discharge guidance.The psychological status(SDS and SAS)and self-management ability of the two groups were evaluated within48 hours after admission,on the first day after the condition was stable,at the time of discharge,one month,three months and six months after discharge,and within 48 hours after admission,one month,three months and six months after discharge The lung function(FEV1/FVC,FEV1% predicted value)and quality of life(CAT)of the two groups wereevaluated at months,and the differences between the two groups were compared.Results1.There were 57 elderly COPD patients in this study,29 in the intervention group and 28 in the control group.Among them,34 cases were male(59.6%)and 23 cases were female(40.4%).The average age was(70.91�7.28)years.There was no significant difference in baseline data,psychological status,self-management ability,lung function and quality of life between the two groups(P>0.05).2.48 h after admission On the first day after the disease was stable,there was no significant difference between the control group and the intervention group(P>0.05)in the scores of all dimensions of self-management ability and the total score of self-management ability;at the time of discharge,there was no statistical significance in the other dimensions of self-management ability of the intervention group except the symptom management dimension(P>0.05);at the first month after discharge,there was no significant difference between the intervention group and the intervention group(P>0.05).The scores of condition management dimension,emotion management dimension and self-efficacy dimension were all higher than those of the control group(P<0.05);three months after discharge,the total scores of self-management ability,symptom management dimension,daily life management dimension,emotion management dimension and self-efficacy management dimension of the intervention group were higher than those of the control group(P<0.05).At 6 months after discharge,the scores of all dimensions of self-management ability and the total scores of self-management ability in the intervention group were statistically significant(P<0.05).3.Within 48 hours after admission and on the first day after the condition was stable,there was no significant difference between the control group and the intervention group(P>0.05);At the time of discharge,one month,three months and six months after discharge,the psychological status of the intervention group was statistically significant(P < 0.05),the psychological status of the intervention group was better than that of the control group at thesame time,and the SDS and SAS scores of the intervention group were significantly reduced.4.Within 48 hours after admission and 1 month after discharge,FEV1 and FEV1 / FVC in the control group had no significant difference with the intervention group(P>0.05);from the intervention to 3 months after discharge,FEV1 in the measurement intervention group was better than that in the control group(P<0.05);at 6 months after discharge,FEV1 and FEV1 / FVC in the measurement intervention group were better than that in the control group(P<0.05).5.Within 48 hours after admission and one month after discharge,there was no significant difference in the quality of life between the control group and the intervention group(P>0.05);after three months of intervention,the scores of five items of cough,expectoration,housework,sleep and energy were better than those of the control group(P<0.05);after six months of intervention,the total scores of the quality of life and the above five items were better than those of the control group(P<0.05).Conclusion1.The discharge plan based on systematic evaluation can improve the psychological status of the elderly patients with COPD;2.The discharge plan based on systematic evaluation can improve the self-management ability,lung function and life quality of the elderly patients with COPD.