Study On The Application Of Pulmonary Rehabilitation Based On The 5A Care Model In Patients With ILD

Objective:The 5A care model(Assess,Advise,Agree,Assist,Arrange)was integrated with pulmonary rehabilitation(PR)in this study to see if the PR program based on the 5A care model has an influence on pulmonary function,quality of life,anxiety and depression,self-efficacy,and rehabilitation compliance in patients with interstitial lung disease(ILD).Our study aims to provide evidence-based and theoretical support for better clinical implementation of PR in patients with ILD.Methods:In this study,64 ILD patients hospitalized in the pulmonary department of a tertiary general hospital in Changchun were assigned randomly to the intervention group(PR treatment based on the 5A care model)and the comparison group(conventional PR treatment),with 32 patients being assigned to each group.The intervention and control groups underwent different modes of PR for 10 weeks each.Before and after the intervention,the patient’s lung function is tested,along with their dyspnea,quality of life,anxiety,depression,and self-efficacy.Just the baseline exercise tolerance is measured.At the end of the intervention,compliance with the rehabilitation was evaluated.For data entry,Epidata 3.1 was used,and statistical analysis was performed by SPSS 26.0.Results:1.General informationA total of 4 patients slipped out of the study: 1 dropped out,1 was missed in the intervention group,and 2 were missed in the control group.As a result,a total of 60 patients with ILD completed the intervention training,30 in the intervention group and 30 in the control group,with a mean age of 59.17 ± 11.66 years,of whom 36 were male and 24 were female.The participants’ general demographic data in the two groups were fairly similar(P >0.05).2.Comparison between groups before and after intervention2.1 Rehabilitation adherence: After the intervention,30.00% of the study subjects in the intervention group were fully adherent,43.33% were partially adherent,and 26.67% were non-adherent,while only 6.67% of the study subjects in the control group were completely adherent,40.00% were partly adherent and 53.33% were non-adherent.The intervention group’s PR adherence was significantly higher than the control group’s(P < 0.05).2.2 Pulmonary function,dyspnea,and quality of life: There was no difference in lung function indicators,dyspnea scores,or quality of life between the two groups before or after the intervention(P > 0.05).2.3 Anxiety and depression: After the intervention,there was no statistical difference in anxiety and depression scores between the two study groups(P > 0.05),which were comparable at baseline.There was a significant improvement in anxiety-depression scores in the intervention group after the intervention compared to the control group(P < 0.05).2.4 Self-efficacy: After the treatment,there was no statistical difference in the PR self-efficacy index scores of the two study groups(P > 0.05),which were nearly equivalent at baseline.After training,the intervention group’s PR self-efficacy index scores were significantly higher than the control group’s(P < 0.05).3.Intra-group comparison after intervention3.1 Pulmonary function: After the end of the intervention,there was only a statistically significant difference in pulmonary function indexes between the control group’s before and after PR for carbon monoxide dispersion(P>0.05)and the intervention group’s carbon monoxide dispersion as a percentage of the anticipated improvement(P<0.01).3.2 Dyspnea: There was a significant difference between the dyspnea scores of the intervention group before and after the intervention(P<0.01),but not between the dyspnea scores of the control group(P>0.05)at the end of the intervention.3.3 Quality of life: At the end of the intervention,both the dimensions of the St.George’s Respiratory Questionnaire and total scores seemed to have lower scores in the intervention group compared with the initial intervention(P<0.01),while only two dimensions of respiratory symptoms,activity limitation,and total scores were markedly enhanced in the control group(P<0.01).3.4 Anxiety and depression: At the end of the intervention,the anxiety score of the intervention group had been significantly lower than pre-intervention(P<0.01),while the depression score remained unchanged(P > 0.05).In contrast,the control group’s anxiety and depression scores did not differ significantly(P > 0.05)before or after the intervention.3.5 Self-efficacy: The PR self-efficacy index scores of the intervention group were considerably higher(P<0.001)at the finish of the intervention,whereas the ratings of the control group declined both before and after the intervention but did not differ statistically(P > 0.05).Conclusions:1.When compared to traditional PR,PR based on the 5A care model dramatically reduced anxiety and depression as well as boosted PR self-efficacy.2.Compared to pre-PR training,individuals with ILD who underwent PR based on the5 A care model saw improvements in their diffusion function,dyspnea,anxiety,and quality of life.3.A powerful PR tool for ILD patients,PR based on the 5A care model can greatly increase ILD patients’ adherence to PR,boosting the use of PR in clinical ILD patients and encouraging more ILD patients to benefit from it.