Self-management activities of older people with chronic obstructive pulmonary disease by types of healthcare services utilised: A cross-sectional questionnaire study
Self-management activities of older people with chronic obstructive pulmonary disease by types of healthcare services utilised: A cross-sectional questionnaire study
复制标题
按所使用的医疗服务类型划分的慢性阻塞性肺疾病老年人的自我管理活动：横断面问卷研究
DOI：
10.1111/opn.12316
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发表时间：
2020
影响因子：
2.2
通讯作者：
Yamamoto-Mitani Noriko
中科院分区：
文献类型：
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作者：
Kitamura Satomi;Igarashi Ayumi;Yamauchi Yasuhiro;Senjyu Hideaki;Horie Takeo;Yamamoto-Mitani Noriko
目的和设计日本的各种医疗服务为患有慢性阻塞性肺疾病（COPD）的老年人提供自我管理干预。为了研究医疗服务利用对自我管理活动的影响，我们对通过门诊诊所（OC）、门诊康复中心（OR）或家庭护理（HC）服务接受护理的COPD老年人进行了一项横断面调查。（a）尽量减少呼吸困难的策略，（B）维持身心健康状态的适当活动，以及（c）与医疗保健专业人员或家庭成员沟通。我们比较了每种情况下的自我管理活动（OC、OR和HC），控制呼吸困难水平和年龄，我们选择这些作为疾病严重程度的代表变量。（n= 81;平均年龄：78.2岁），HC组（n= 25）的参与者COPD水平最严重，其次是OR组（n= 31）和OC组（n= 12）。与OC组的参与者相比，OR组和HC组的参与者更多地报告了自我管理活动，例如“与呼吸相对应的移动身体”（OR：调整后的比值比[AOR]，6.71; HC：AOR，6.98），“尽量不要快速移动”（OR：AOR，5.46），“避免窒息运动”（HC：AOR，7.37），“接种流感疫苗”（OR：AOR，8.12; HC：AOR，7.81），“伸展运动”（OR：AOR，6.42; HC：AOR，16.76），“肌肉训练”（OR：AOR，8.49; HC：AOR，9.73）和“与医疗保健专业人员讨论生活方式目标”（HC：AOR，5.75）控制呼吸困难水平和年龄后。（如呼吸技巧和家庭锻炼）与使用OR或HC服务相关，对实践的启示研究结果表明，我们应该提供额外的服务，如OR和HC除了OC老年COPD患者谁不能进行自我管理活动。我们需要考虑策略，根据每个医疗服务环境的独特特点，为每个环境提供有效的自我管理干预。
Aims and designVarious healthcare services in Japan provide self‐management interventions for older people with chronic obstructive pulmonary disease (COPD). To examine the influence of healthcare service utilisation on self‐management activities, we conducted a cross‐sectional survey of older people with COPD who received care through outpatient clinics (OC), outpatient rehabilitation centres (OR) or home care (HC) services.MethodsThe survey consisted of 34 originally developed self‐report questions about three types of self‐management activities: (a) strategies to minimise dyspnoea, (b) appropriate activities to maintain physical and mental health status and (c) communication with healthcare professionals or family members. We compared self‐management activities in each setting (OC, OR and HC) using logistic regression analyses, controlling for dyspnoea level and age, which we chose as representative variables of disease severity.ResultsAmong the total sample (n= 81; mean age: 78.2 years old), participants in the HC group (n= 25) had the most severe level of COPD, followed by those in the OR (n= 31) and OC (n= 12) groups. Compared with participants from the OC group, more participants from the OR and HC groups reported self‐management activities, such as “moving body corresponding to breathing” (OR: adjusted odds ratio [AOR], 6.71; HC: AOR, 6.98), “trying not to move quickly” (OR: AOR, 5.46), “avoiding suffocating movements” (HC: AOR, 7.37), “getting an influenza vaccination”(OR: AOR, 8.12; HC: AOR, 7.81), “stretching exercise” (OR: AOR, 6.42; HC: AOR, 16.76), “muscle training” (OR: AOR, 8.49; HC: AOR, 9.73) and “discussing lifestyle goals with healthcare professionals” (HC: AOR, 5.75) after controlling for dyspnoea level and age.ConclusionsSome self‐management activities (such as breathing techniques and home exercise) were associated with the use of OR or HC services, an effect persisting after adjusting for degree of breathlessness and age.Implications for practiceFindings suggest that we should provide additional services such as OR and HC besides OC to older people with COPD who are unable to practice self‐management activities. We need to consider strategies to provide effective self‐management intervention in each healthcare service setting according to the unique characteristics of each setting.