| Objective:To understand the needs of patients with COPD for discharge planning services and to explore the effects of discharge planning based on BCW theory on the self-management ability,COPD health literacy and quality of life for COPD patients,The aim is to provide a reference basis for clinical promotion of active and effective self-management of COPD patients.Methods:This study adopts the method of combining qualitative research and quantitative research.1.Qualitative research stage: Using a phenomenological study method and purposive selection,15 patients with COPD who were hospitalized in a tertiary care hospital in Shanxi Province from August 2021 to October 2021 were selected as the study subjects.By reviewing literature and books,preparing an interview outline,and conducting semi-structured interviews with patients;applying Colaizzi analysis to analyze the data,the themes of their discharge planning needs were derived to provide a basis for the development of discharge planning cases for COPD patients.2.Quantitative research stage: Using quasi-experimental study methods,110 COPD patients who were hospitalized in the respiratory medicine department of a tertiary hospital in Shanxi Province from December 2021 to June 2022 and met the inclusion criteria were selected as study subjects.According to the ward group,the first respiratory ward was the control group,and the second respiratory ward was the intervention group.The COPD patients in the control group received routine health education in the hospital,and the intervention group received a discharge planning intervention program based on BCW theory.The COPD self-management ability scale,COPD health literacy scale and quality of life CAT scale were used to measure the scores of the two study groups before,3months after,and 6 months after the intervention.SPSS26.0 software was applied to process and analyze the experimental data to evaluate the effectiveness of the discharge planning based on BCW theory in patients with COPD.Result:1.The qualitative study summarized five themes of COPD patients’ needs for discharge planning care: disease health knowledge needs,respiratory function training instruction needs,psychological adjustment needs,multidimensional social support needs and health resource service utilization needs.2.At the end of the intervention,a total of 105 patients completed the study,including2 cases of shedding in the intervention group,totaling 53 cases,and 3 cases of shedding in the control group,totaling 52 cases.3.Before the intervention,the general information,total score and each dimension score of self-management ability,COPD health literacy score,and CAT score of quality of life of the two groups were compared,and the differences were not statistically significant(P>0.05)and were balanced and comparable.4.After 3 and 6 months of intervention,the total self-management ability scores of patients in the intervention group were(170.55±6.23)and(183.34±7.08),respectively,which were higher than the total self-management ability scores of the control group(149.00±6.44)and(150.88±7.11),and the differences were statistically significant(P<0.05).Repeated-measures ANOVA showed that there was a significant between-group effect and within-group effect for the total score and each dimension score of self-management ability in both groups,and there was an interaction effect between the two(P<0.05).5.After 3 and 6 months of intervention,the COPD health literacy scores of patients in the intervention group were(8.25±1.68)and(9.26±1.69),respectively,which were higher than those of the control group(5.98±1.74)and(6.33±1.49),and the differences were statistically significant(P<0.05).Repeated-measures ANOVA showed that there was a significant between-group effect and within-group effect for COPD health literacy scores in both groups,and there was an interaction effect between the two(P<0.05).6.After 3 and 6 months of intervention,the quality of life CAT scores of patients in the intervention group were(23.98±3.21)and(21.64±3.70),respectively,which were lower than the quality of life CAT scores of the control group(27.56±2.98)and(26.67±3.54),and the differences were statistically significant(P<0.05).Repeated-measures ANOVA showed that there was a significant between-group effect and within-group effect for the two groups of patients with quality of life CAT scores,and there was an interaction effect between the two(P<0.05).Conclusion:1.The discharge planning needs of COPD patients are not fully met,and there is a high demand for guidance on disease management,psychological and social support.Clinical workers should provide individualized discharge planning plans for patients according to their different needs.2.The discharge planning program based on BCW theory can improve the self-management ability and health literacy level of COPD patients to a certain extent,help patients change their bad behaviors and reduce the risk of readmission,thus effectively improve their quality of life. |
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