跨理论模型联合健康信念模型护理干预在肺结核合并慢性阻塞性肺疾病患者中的应用效果

doi:10.19982/j.issn.1000-6621.20250037

中国防痨杂志 ›› 2025, Vol. 47 ›› Issue (6): 727-731.doi: 10.19982/j.issn.1000-6621.20250037

跨理论模型联合健康信念模型护理干预在肺结核合并慢性阻塞性肺疾病患者中的应用效果

彭华¹, 崔俊伟²(), 尚秋白², 李四清², 彭瑞琴³

¹河南省新乡医学院第一附属医院护理部,卫辉 453100
²河南省新乡医学院第一附属医院结核内科二病区,卫辉 453100
³河南省新乡学院护理学院,新乡 453000

收稿日期:2025-01-23 出版日期:2025-06-10 发布日期:2025-06-11
通信作者: 崔俊伟,Email:cjw8693@163.com
基金资助:
河南省卫生健康委项目(LHGJ20230525);河南省财政厅和河南省卫生健康委项目[豫财社(2023)68号];河南省科技厅项目(242102310202)

Effectiveness of a nursing intervention based on the Transtheoretical Model combined with the Health Belief Model in patients with pulmonary tuberculosis and chronic obstructive pulmonary disease

Peng Hua¹, Cui Junwei²(), Shang Qiubai², Li Siqing², Peng Ruiqin³

¹Department of Nursing, The First Affiliated Hospital of Xinxiang Medical University, Henan Province, Weihui 453100, China
²Second Tuberculosis Ward, The First Affiliated Hospital of Xinxiang Medical University, Henan Province, Weihui 453100, China
³School of Nursing, Xinxiang University, Henan Province, Xinxiang 453000, China

Received:2025-01-23 Online:2025-06-10 Published:2025-06-11
Contact: Cui Junwei, Email: cjw8693@163.com
Supported by:
Henan Provincial Health Commission Project(LHGJ20230525);Henan Provincial Department of Finance & Health Commission Project (Yu Cai She(2023) No.68);Department of Science and Technology of Henan Province(242102310202)

摘要/Abstract

摘要：

目的: 探讨基于跨理论模型(the transtheoretical model,TTM)联合健康信念模型(health belief model,HBM)的护理干预措施在肺结核合并慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者中的应用效果。方法: 采用回顾性研究方法,选择2021年4月1日至2023年3月31日新乡医学院第一附属医院收治的肺结核合并COPD患者146例作为研究对象。其中,2021年4月1日至2022年3月31日收治的73例患者作为对照组,采用常规护理方法进行护理;2022年4月1日至2023年3月31日收治的73例患者作为观察组,采用基于TTM联合HBM的护理模式进行护理。比较两组患者出院后3个月的肺功能、自我管理能力、服药依从性、生活质量变化情况。结果: 出院后3个月,对照组第1秒用力呼气容积(forced expiratory volume in one second,FEV₁)、用力肺活量(forced vital capacity,FVC)、第1秒用力呼气容积与用力肺活量比值(FEV₁/FVC)分别为(1.67±0.15)L、(2.56±0.18)L、0.65±0.03;观察组分别为(1.99±0.19)L、(2.81±0.21)L、0.71±0.04;观察组各肺功能指标均明显高于对照组,差异均有统计学意义(t值分别为-11.186、-7.792、-9.311,P值均<0.01)。对照组自我管理能力、服药依从性、生活质量评分分别为(4.56±1.35)分、(5.29±1.11)分、(66.08±8.66)分;观察组分别为(6.03±1.22)分、(6.99±0.87)分、(73.68±10.99)分;观察组各项评分均明显高于对照组,差异均有统计学意义(t值分别为-6.858、-10.188、-4.639,P值均<0.01)。结论: 基于TTM联合HBM的护理干预有助于改善肺结核合并COPD患者肺功能,同时提高患者自我管理能力和服药依从性,促进生活质量的改善。

关键词: 结核,肺, 肺疾病,慢性阻塞性, 共病现象, 康复护理, 护理评价研究

Abstract:

Objective: To evaluate the effectiveness of a nursing intervention based on the Transtheoretical Model (TTM) integrated with the Health Belief Model (HBM) in patients diagnosed with pulmonary tuberculosis (PTB) and coexisting chronic obstructive pulmonary disease (COPD). Methods: This retrospective study included 146 patients diagnosed with both PTB and COPD who were admitted to the First Affiliated Hospital of Xinxiang Medical University between April 1, 2021, and March 31, 2023. Of these, 73 patients admitted from April 2021 to March 2022 received routine nursing care (control group), while the remaining 73 patients admitted from April 2022 to March 2023 received a nursing intervention based on the integrated TTM-HBM model (intervention group). Outcomes were assessed three months after discharge, including pulmonary function parameters, self-management ability, medication adherence, and quality of life. Results: At the three-month post-discharge follow-up, patients in the intervention group exhibited significantly greater improvements across all outcome measures compared with those in the control group. Pulmonary function parameters were markedly better in the intervention group, including forced expiratory volume in one second (FEV₁: (1.99±0.19) L vs. (1.67±0.15) L; t=-11.186, P<0.01), forced vital capacity (FVC: (2.81±0.21) L vs. (2.56±0.18) L; t=-7.792, P<0.01), and the FEV₁/FVC ratio (0.71±0.04 vs. 0.65±0.03; t=-9.311, P<0.01). Similarly, the intervention group scored significantly higher in self-management ability (6.03±1.22 vs. 4.56±1.35; t=-6.858, P<0.01), medication adherence (6.99±0.87 vs. 5.29±1.11; t=-10.188, P<0.01), and quality of life (73.68±10.99 vs. 66.08±8.66; t=-4.639, P<0.01). Conclusion: A nursing intervention grounded in the integrated TTM and HBM yields significant clinical benefits for patients with PTB and coexisting COPD. This approach not only enhances pulmonary function but also improves patients’ self-management abilities and medication adherence, ultimately contributing to sustained improvements in quality of life.

Key words: Tuberculosis, pulmonary, Pulmonary disease, chronic obstructive, Comorbidity, Rehabilitation nursing, Nursing evaluation research

中图分类号:

R473.5
R521

彭华, 崔俊伟, 尚秋白, 李四清, 彭瑞琴. 跨理论模型联合健康信念模型护理干预在肺结核合并慢性阻塞性肺疾病患者中的应用效果[J]. 中国防痨杂志, 2025, 47(6): 727-731. doi: 10.19982/j.issn.1000-6621.20250037

Peng Hua, Cui Junwei, Shang Qiubai, Li Siqing, Peng Ruiqin. Effectiveness of a nursing intervention based on the Transtheoretical Model combined with the Health Belief Model in patients with pulmonary tuberculosis and chronic obstructive pulmonary disease[J]. Chinese Journal of Antituberculosis, 2025, 47(6): 727-731. doi: 10.19982/j.issn.1000-6621.20250037

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参考文献 15

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组别	FEV₁(L)		FVC(L)		FEV₁/FVC
组别	干预前	干预后	干预前	干预后	干预前	干预后
对照组	1.36±0.13	1.67±0.15	2.21±0.18	2.56±0.18	0.62±0.03	0.65±0.03
观察组	1.33±0.11	1.99±0.19	2.15±0.12	2.81±0.21	0.61±0.02	0.71±0.04
t值	1.648	-11.186	2.155	-7.792	0.087	-9.311
P值	0.102	<0.01	0.062	<0.01	0.928	<0.01

跨理论模型联合健康信念模型护理干预在肺结核合并慢性阻塞性肺疾病患者中的应用效果

Effectiveness of a nursing intervention based on the Transtheoretical Model combined with the Health Belief Model in patients with pulmonary tuberculosis and chronic obstructive pulmonary disease

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参考文献 15

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组别	干预前	干预后
对照组	3.47±1.33	4.56±1.35
观察组	3.69±1.12	6.03±1.22
t值	-0.651	-6.858
P值	0.517	<0.01

组别	干预前	干预后
对照组	4.11±0.81	5.29±1.11
观察组	4.34±0.71	6.99±0.87
t值	-1.850	-10.188
P值	0.073	<0.01

组别	干预前	干预后
对照组	55.41±16.11	66.08±8.66
观察组	58.19±13.18	73.68±10.99
t值	-1.142	-4.639
P值	0.264	<0.01

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