A Study On The Construction Of TCM Health Education Program By Top-setting Key Factors For Elderly Patients With COPD

Objective:The purpose of this study is to construct a health education module highlighting TCM health management intervention,and the key elements were put on the top in combination with the "28" rule,so as to form the TCM health education program by top-setting key factors for elderly patients with COPD.Methods:(1)Through literature research,the contents of COPD health education guidelines and literature were analyzed with 5W1 H analysis method.Content of traditional Chinese medicine health education program for elderly COPD patients was selected..(2)The qualitative research method was used to interview 12 medical workers in the respiratory department of a third-grade hospital of traditional Chinese medicine,and the content analysis method was used to condense and group the important contents and extract the themes.To understand the status quo and application of traditional Chinese medicine health education for elderly COPD patients,supplement and improve the content of traditional Chinese medicine health education program for elderly COPD patients.(3)Hold an expert meeting to demonstrate the health education program of traditional Chinese medicine for elderly COPD(draft),and form a Delphi expert consultation table.Followed by two rounds of Delphi expert consultation.The coefficient of experts' active degree,authority degree,judgment coefficient and coordination coefficient were calculated,and the variation's coefficient of each item was statistically analyzed.20% of the content is extracted as the key content,and the rest is the general content,so as to form a TCM health educationprogram by top-setting key factors.(4)In this study,31 patients who met the COPD diagnostic criteria and inclusion criteria were selected from 2 third-grade hospital of traditional Chinese medicine in Hunan province.By means of random lottery,they were divided into the intervention group and the control group,among which 16 cases in the intervention group received the TCM health education by top-setting key factors,and 15 cases in the control group received the TCM health education program(non-key health education)constructed in this study.Five health education programs were carried out(the first health education,after 30 min,after 1d,after2 d and after 4d).The number of items in memory,KAP level and CAT level were evaluated in both groups.SPSS22.0 statistical software was used for statistical analysis.Measurement data were subject to t test for normal distribution,and non-parametric test for non-normal distribution.Descriptive analysis and chi-square test were used for enumeration data.Results:(1)A total of 3 guidelines and 18 randomized controlled trials were included through evidence-based studies.Through 5W1 H analysis method to analyze the guide and literature.The contents of daily living,diet,emotion,traditional Chinese medicine exercises,proper technology conditioning of TCM and others(including awareness of the causes and symptoms of the disease,self-assessment,measures to identify and manage deterioration and so one)are summarized(2)In the qualitative research,a total of 5 topics related to the health education status of COPD in the elderly were summarized.The contents of TCM health education should involve8 aspects,such as drug use,daily life,diet,respiratory function exercise,proper technology conditioning of TCM,emotional and spiritual conditioning,oxygen therapy,and smoking cessation.(3)After the expert meeting and two rounds of Delphi expert consultation,the TCM health education program for elderly COPD was determined,including 5 first-level indicators,17second-level indicators,and 34 specific contents.According to its mean score,the top 20% of contents were selected to form the key contents(8 contents involved 5 aspects)and general contents.The positive coefficient of experts in two rounds of Delphi consultation was 80% and 70% respectively,the coefficient of expert authority was 91.55% and 91.05%,After two rounds of expert consultation,the variation coefficient of each item fluctuated slightly,both < 0.3.Kendall's W of rationality,necessity and feasibility were 0.143,0.246 and 0.309,respectively,and all P values were < 0.01,showing significant statistical differences.Conclusion:In this study,a TCM health education program for elderly COPD patients was constructed,including daily living conditioning,diet conditioning,emotion conditioning,proper technology conditioning of TCM,and traditional Chinese medicine exercise conditioning.The key elements in the plan were determined and the TCM health education program by top-setting key factors for elderly patients with COPD was formed.The determination of key elements is scientific to a certain extent through the process of literature,interviews,expert meetings and Delphi expert consultation.The results of expert positive coefficient,authority coefficient,coordination coefficient and variation coefficient of each item indicate showed that the scheme has high credibility and reliability,and the items have good consistency.