Study of Continuous Nursing Intervention to Patients Using Home NIPPV with COPD
|School||Tianjin Medical University|
|Keywords||Chronic obstriletive pulmonary disease Continnous nursing HomeNoninvasive Positive Pressure Ventilation life quality Treatment adherence|
ObjectiveThrough evaluation of health problems and health needs in patients at Home Noninvasive Positive Pressure Ventilation with chronic obstructive pulmonary disease,to make suitable intervention plan for such patients, implement continuous nursing intervention of relevant knowledge, rehabilitation exercise, noninvasive ventilation health guide, breathing machine maintenance, to assess the effect on patients lung function, blood gas index, quality of life, breath difficult degree, treatment adherence, sports ability, wearing machine complications. To explore the continuous nursing mode which is appropriate for patients from hospital to family.MethodsFrom existing NIPPV patients choosing50cases of COPD patients the archives in October2010to June2011in respiration department in tianjin medical university general hospital after discharge, all patients have bought noninvasive machine. Machine types are suitable for family of American futong series products.Randomly divided into intervention group and control25cases.collecting basic material when discharge, after discharge intervention group of patients with continuous nursing care. Intervention includes knowledge instruction, rehabilitation guidance, noninvasive ventilation health guidance and machines maintenance instruction, etc, making health education manual to dicharge patients.Results1.two groups with lung function, blood gas index, quality of life, index of difficulty breathing,6minutes walk test, oxygen untake time, treatment adherence, wear machine complications are no statistically significant difference in discharge (P<0.05).After intervention Lung function has not seen obvious change.2. Intervention group PCO2, PO2, quality of life, dyspnea index have statistically significant in discharged6months compared with dischargand discharge one months (P<0.05).Discharge6months intervention group PCO2, PO2, quality of life, and the dyspnea index is better than discharge,and better than the control group.3.Intervention group oxygen time discharge1months compared with discharge is statistically significant difference (P<0.05), control group discharge1month,6months respectively compared with discharge are statistics difference (P<0.05). Intervention group discharge1months of oxygen time is less than discharge, intervention group discharge6months oxygen time is longer than control group.3. Intervention group treatment adherence total score discharge6months compared with the discharge1months have statistical significant (P<0.05), exercise, review scores in intervention in groups of two compared are statistics difference (P<0.05), drug using, wear machine scoring intervention group discharge6months,1months compared with the hospital statistically significant (P<0.05). Discharge6months intervention group treatment adherence better than discharge and the control group.4.Wear machine complications compared in the group, oropharyngeal dry,facial crushed,air leakage in discharge6months have statistically significant compared with discharge(P<0.05). Wear machine complications in intervention group were less than the number in the control group.Conclusions1.The lung function of chronic obstructive pulmonary disease with Home Noninvasive Positive Pressure Ventilation were no obvious sound effects after continuous nursing intervention.But continuous nursing intervention can improve patients’ arterial blood gas, the quality of life, reduce patients symptom of breathe difficulty, improve patient walking distance, increase patient endurance activities.2. Continuous nursing intervention improves patients PO2,drop PCO2which can’t be sure, oxygen time after intervention was not seen significant rise.but its improving the patient treatment adherence, reducing wear machine of the complications have obvious effect.3.Curative effect of the copd with Home Nippv is still controversial, but Home Nippv has become the trend of development in recent years, continuous nursing mode from hospital to the family can make patients benefit.