患者主导型护理模式在哮喘自我管理中的应用及效果评价

Application and Effect Evaluation of Patient-Centered Care Model in Asthma Self-Management

摘要: 目的：探讨患者主导型护理模式在支气管哮喘患者自我管理中的应用效果。方法：采用随机对照试验设计，纳入2024年1~12月70例哮喘患者，随机分为观察组(n = 35)与对照组(n = 35)。观察组实施患者主导型护理模式，包括个性化教育、智能监测、协作决策及同伴支持，干预6个月；对照组接受常规护理(健康教育手册、电话随访及门诊复诊)。比较两组基线、干预3个月及6个月的肺功能(FEV1%预计值)、哮喘控制测试(ACT)评分、Morisky用药依从性量表(MMAS-8)及哮喘自我效能量表(ASES)评分。结果：干预后，观察组FEV1%预计值从76.42 ± 9.64提升至88.71 ± 7.12 (P < 0.001)，ACT评分从17.23 ± 3.54升至22.46 ± 2.15 (P < 0.001)，MMAS-8评分提高41.3% (7.35 ± 0.85 vs. 5.20 ± 1.30, P < 0.001)，ASES评分达73.64 ± 8.75 (P < 0.001)，均显著优于对照组(P < 0.05)。两组均未发生严重不良反应。结论：患者主导型护理模式通过数字化动态管理及协作决策机制，可有效改善哮喘患者肺功能、症状控制及自我管理能力，且安全性良好。

Abstract: Objective: To explore the application effect of the patient-centered care model in the self-management of patients with bronchial asthma. Methods: A randomized controlled trial design was adopted. 70 asthma patients from January to December 2024 were included and randomly divided into the observation group (n = 35) and the control group (n = 35). The observation group implemented the patient-centered care model, including personalized education, intelligent monitoring, collaborative decision-making, and peer support, with an intervention period of 6 months; the control group received routine care (health education manual, telephone follow-up, and outpatient follow-up). The baseline, 3-month intervention, and 6-month intervention of lung function (FEV1% predicted value), asthma control test (ACT) score, Morisky Medication Adherence Scale (MMAS-8), and asthma self-efficacy scale (ASES) score were compared between the two groups. Results: After the intervention, the FEV1% predicted value of the observation group increased from 76.42 ± 9.64 to 88.71 ± 7.12 (P < 0.001), the ACT score increased from 17.23 ± 3.54 to 22.46 ± 2.15 (P < 0.001), the MMAS-8 score increased by 41.3% (7.35 ± 0.85 vs. 5.20 ± 1.30, P < 0.001), and the ASES score reached 73.64 ± 8.75 (P < 0.001), all of which were significantly better than those of the control group (P < 0.05). No serious adverse reactions occurred in both groups. Conclusion: The patient-centered care model, through digital dynamic management and collaborative decision-making mechanisms, can effectively improve the lung function, symptom control, and self-management ability of asthma patients, and has good safety.