提升慢性阻塞性肺部疾病住院病人的肺復健率

Improving Chronic Obstructive Pulmonary Disease Patients' Pulmonary Rehabilitation Rate

10.29936/DMFCCHJN.201006.0003

蔡琇如(Hsiu-Ju Tsai)；林秋燕(Chiu-Yen Lin)；蔡鳳玉(Fung-Yu Tsai)；林明憲(Ming-Shian Lin)；余美嬅(Mei-Hua Yu)；郭雅慧(Ya-Hui Kuo)

慢性阻塞性肺部疾病 ； 住院病人 ； 肺復健 ； chronic obstructive pulmonary disease ； hospitalized patients ； pulmonary rehabilitation

嘉基護理

10卷1期（2010 / 06 / 01）

15 - 25

繁體中文

肺復健可改善慢性阻塞性肺部疾病病人呼吸困難，增加運動耐受力、減少住院天數及提昇生活品質。2008年6月1日至9月30日本病房慢性阻塞性肺部疾病66病人中適合肺復健者58位，完成肺復健療程僅22位(37.9%)，因而成立專案小組進行改善。經現況分析，發現導致病人肺復健率偏低原因：1．護理人員方面一對肺復健知識不足、未及時給予衛教；2．病人方面一對肺復健知識缺乏、復健時間過長、疾病及生理因素等。改善方法為：舉辦護理人員在職教育、製作衛教單張、跨科室討論會研擬病人復健個別性計畫、設置簡易的運動空間、辦理團體衛教及影片觀賞等。專案實施後，護理人員對肺復健瞭解程度由82.4分提升為100分，病人對於肺復健認知瞭解程度由56.4分進步至78.6分、執行肺復健率由37.9%提升為100%，並能持續維持。

Pulmonary rehabilitation is important in planning efficacious therapy on hospitalized chronic obstructive pulmonary disease (COPD) patients, which could improve dyspnea, exercise tolerance. decrease length of hospital stay and enhance quality of life. From Jane 1, 2008 to September 30, 2008, sixty-six COPD patients were in our ward. A total of fifty-eight patients met the criteria for participation pulmonary rehabilitation program. In contrast, we found that only twenty-two patients complete the program, the complete rate was 37.9%. The project team analyzed data from interviewing incomplete the program patients and tested nursing staffs' score of pulmonary rehabilitation knowledge. The factors of causing the poor pulmonary rehabilitation rate possible were: 1. nursing staff-insufficient pulmonary rehabilitation knowledge, inadequate patient education; 2. patients-insufficient pulmonary rehabilitation knowledge, prolonged rehabilitation time, illness and physical factors. Our strategies included educated nursing staff, designed pulmonary rehabilitation leaf, cross-discipline meeting designed individualized pulmonary rehabilitation program, set suitable exercise environment at ward, took placed group patient education, and video viewing. After strategies were implemented, nursing staffs' score of pulmonary rehabilitation knowledge improved from 82.4 to 100, patients' of pulmonary rehabilitation knowledge also improved from 56.4 score up to 78.6, the pulmonary rehabilitation rate was from 37.9% up to 100%.