AECOPD病人应用BiPAP呼吸机治疗的依从性因素调查及护理干预

目的:通过对需使用BiPAP呼吸机治疗的AECOPD患者及家属进行调查,分析影响使用呼吸机依从性的因素,并探讨护理干预的效果。方法:选取2010年1月至2011年3月在呼吸科住院需使用BiPAP呼吸机治疗的AECOPD患者120例,调查患者对使用BiPAP呼吸机的顾虑因素及家属对呼吸机治疗的认同程度,根据患者特点进行护理干预,并比较干预前后患者家属对使用呼吸机治疗的认同程度变化和患者使用呼吸机依从率变化。结果:使用前患者担忧呼吸机安全的占34.17%,有恐惧感的占26.67%,对治疗费用有顾虑的占18.33%,对今后可能购机费用担忧的占33.33%,对是否会出现呼吸机依赖担忧的占12.50%。使用呼吸机前患者家属完全同意、不确定、不同意的比例分别为58.33%、16.67%和24.17%,而患者的依从率为47.50%;护理干预后,患者家属完全同意、不确定、不同意的比例分别为94.17%、2.50%和3.33%,而患者的依从率提高至93.30%。护理干预前后患者家属认同程度及患者依从性比较,差异有统计学意义(P<0.05)。而患者家属认同程度改善与依从率提高具有明显的相关性(r=0.56)。结论:AECOPD病人应用BiPAP呼吸机治疗的依从性与多种因素有关,根据患者特点制定个体化的护理干预方案能明显提高患者治疗的依从性。

The Influencing Factors on Compliance and Nursing Intervention of BiPAP Assisted Ventilation in Treatment of AECOPD

Objective： To investigate the factors affecting the compliance of the patients with AECOPD ventilated by BiPAP and study the efficacy of corresponding nursing intervention measures.Methods： 120 inpatients with AECOPD treated by requisite BiPAP in the department of respiratory medicine during January 2010-March 2011 were selected.The influencing factors and the recognitive degree of patients′ family for using BiPAP assisted ventilation were studied.Furthermore,the recognitive degree changes of patients′ family and the compliance changes of patients were compared before and after the nursing intervention.Results： Before using BIPAP,the percentage of those who worried about the safety of ventilator,who feared it,who took its cost into account,who worried about the high cost from buying it,who doubted the future possible dependence on it,was 34.17%,26.67%,18.33%,33.33% and 12.50%,respectively.As for the family members,the proportion of agreement,uncertainty and disagreement was 58.33%,16.67% and 24.17%,respectively.Besides,the rate of patients′compliance was 47.50%.However,after the nursing intervention,the proportion of agreement,uncertainty and disagreement was 94.17%,2.50% and 3.33%,respectively,while the rate of patients′compliance rose to 93.30%.To compare before nursing intervention with after it,the difference of patients′ compliance and the recognitive degree of their family on BiPAP ventilation were statistically significance（P0.05）.Furthermore,the improvement of family recognitive degree was correlated with patients′ compliance significantly（r=0.56）.Conclusion： The compliance of patients with AECOPD ventilated by BiPAP was associated with multiple factors.The individual nursing intervention measures could improve the patients′ compliance obviously.