Construction And Application Of Self-management Program For COPD Patients Based On HAPA Theory

ObjectiveThis research uses the HAPA theory as the basis and framework to construct a self-management program and analyze and evaluate the impact of the program on patients with COPD,with a view to the program providing a basis for clinical application and practice.Method1.HAPA theory-based intervention program construction phase: extensive review of relevant literature as well as based on the needs of the study to determine the search terms,systematic search of China Knowledge Network,China Biomedical Literature Database,Wanfang,Wipu Chinese database and Pub Med,Cochrane,Web of science,Embase English database,and search period for the establishment of the database to 2021 The search period was until October 18,2021.A preliminary intervention plan was developed based on the HAPA theory through literature research,and the first draft of the intervention plan was formed after group discussion.In order to ensure the scientific and feasibility of the intervention plan,expert or meetings were organized and conducted to revise and improve the first draft of the intervention plan,and the patients were pre-tested before the formal intervention,and the intervention plan was adjusted according to the problems that appeared in the pre-test,and the final draft of to the intervention plan was finally formed.2.application phase of the intervention program based on HAPA theory: according to the established inclusion and exclusion criteria,patients with COPD who were hospitalized in a tertiary care hospital in Kaifeng,Henan Province from December 2021 to July 2022 were selected as study subjects.Patients were divided into intervention and control groups according to the order of admission,with the control group implementing and conventional nursing interventions and the intervention group implementing an intervention program based on HAPA theory on top of to conventional care.Before the intervention,1 month after the intervention and 3 months after the intervention,the patients in both groups filled in the corresponding data and collected them in time.The study instruments included to general information questionnaire,selfmanagement scale,chronic disease self-efficacy scale and dyspnea scale.Result1.Construction stage of the intervention program based on HAPA theory: based on the search terms and the search library,2082 papers were retrieved and 13 papers were finally included,and the first draft of the intervention program was formed after summarizing the included papers in Eight experts were invited to participate in the expert meeting to revise to the preliminary draft of the invention program,and the authority coefficient of the experts was 0.90,which has a high authority.Six patients who met the inclusion and exclusion criteria were selected for the pre-experiment,and the final draft of the intervention was formed with a duration of 3 months.2.Application phase of the intervention program based on HAPA theory:(1)In this study,2 patients were lost in each of the two groups,and a total of 4 patients were lost,and the number of patients with COPD who finally completed for the experiment was 76.The general demographic data and disease-related diseases of to the patients in the two groups were not statistically significant(P > 0.05)and were comparable.(2)The self-management ability of the two groups was not statistically significant before the implementation of the intervention(P > 0.05);after the implementation of the intervention,in the self-management ability of the intervention group was significantly to higher than that of the control group,and the difference was statistically significant(P < 0.05);the results of the repeated measures ANOVA showed that there were time effects,between-group effects and interaction effects at three different time points for the self-management ability of the two groups,and the difference was statistically significant,(P < 0.001).The difference was statistically significant(P < 0.001).(3)The self-efficacy of the two groups,before the implementation of the intervention,was not statistically significant(P > 0.05);after the implementation of the intervention,the self-efficacy of the intervention group was significantly higher to than that of the control group,and the difference was statistically significant(P < 0.05);the results of the repeated measures ANOVA showed that of there were time effects,between-group effects and interaction effects at three different time points for the two groups,and the differences were statistically significant,(P < 0.001).(4)The quality of life of the two groups was scored using CAT,before the implementation of the intervention,the quality of life of the two groups,and difference was not statistically significant(P > 0.05);after the implementation of the intervention,the quality of life of the intervention group was significantly higher than that of the control group,and difference was statistically significant(P < 0.05);the results of the repeated measures ANOVA showed that the quality of life of the two groups existed at three different time points The results of the repeated measures ANOVA showed that there was a time effect,in a group effect and an interaction effect between the two groups at three different time points,and the differences were statistically significant,(P < 0.001).(5)The degree of dyspnea in the two groups was not statistically significant before the implementation of the intervention(P > 0.05);after in the implementation of the intervention,and the degree of dyspnea in the intervention group was significantly lower than that in the control group,and the difference was statistically significant(P < 0.05);in the results of the repeated measures ANOVA showed that there were time effects,group effects and interaction effects at three different time points for the degree of dyspnea in the two groups,and the difference was statistically significant,(P < 0.001).effects at three different time points,with statistically significant differences,(P < 0.001).(6)The two groups of patients showed by chi-square test that the difference was not statistically significant at the stage of behavior change before the intervention(P > 0.05);after the implementation of the intervention,the number of patients in the intervention and in group with behavior change was significantly higher than that in the control group,and the difference was statistically significant(P < 0.05).ConclusionThe intervention program constructed based on the HAPA theory can improve patients’ self-management ability and level,strengthen their self-efficacy,improve their quality of life,and reduce the occurrence of readmission due to disease exacerbation,reduce the degree of respiratory distress,and promote the transformation of patients to a healthy behavioral stage.