建構慢性阻塞性肺疾病者居家肺部復健衛教手冊

Established the Home-Based Pulmonary Rehabilitation Manual in Patients with COPD

背景/ 目的：肺部復健可有效改善慢性阻塞性肺疾病（Chronic obstructive pulmonary disease, COPD）者呼吸短促、運動耐力和生活品質，通常以門診或醫院為基礎，但各國COPD 者接受肺部復健的比率低且流失率高。本研究目的在發展「慢性阻塞性肺疾病者居家肺部復健衛教手冊」，以提升居家COPD者對肺部復健的執行。研究方法：本研究參考多位學者發展量表的步驟，修改作為建構本衛教手冊之六大程序。依據李克特量表（Likert scale） 五點選項（5：非常同意；1：非常不同意）進行衛教手冊「內容適用性」、「內容正確性」與「文字易讀性」之內容效度指標值（Content validity index, CVI） 計算。研究結果：本衛教手冊內容包含：何謂肺部復健、疾病認知、戒菸、藥物指導、呼吸技巧、氧氣治療、運動訓練、營養原則、壓力控制、自我管理技巧等。整體Likert scale 平均為4.13，在內容適用性、內容正確性、與文字易讀性的專家內容效度CVI 值分別為0.71、0.81、0.74，整體衛教手冊的專家內容效度CVI 值達0.75。結論：居家COPD 者的照護與管理責任落在病人與家屬身上。居家COPD 病人在疾病認知、藥物正確使用方法、症狀自我管理、呼吸技巧、運動訓練與心理壓力調適等都需要再加強。期望本衛教手冊能增進COPD 患者居家執行肺部復健之能力，改善其生活品質。

Background/ Purpose: Pulmonary rehabilitation (PR) significantly improve shortness of breath,exercise tolerance and quality of life in patients with COPD. The patients who taken the PR programusually came from outpatient department or hospital and had low participation rate and high dropout ratein PR program. The purpose of this study was to develop the home-based PR manual for patients with COPD, and to enhance the ability of home-based COPD patients performed PR program.Methods: This study modified numbers of the scholars’ methods and then revised them to six stepsin the questionnaire to construction of the PR manual. According to the Likert scale five-point scales tocalculate the content validity index (CVI).Result: This PR Manual contents included: definition of PR, cognition of disease, quit smoking,medications guidance, breathing skills, oxygen therapy, exercise training, nutrition principles, stresscontrol, self-management skills etc. The overall mean score of this PR manual was 4.13. The experts’CVI of content applicability, correctness, and text legibility in the home-based PR manual was 0.71, 0.81and 0.74, and the experts’ CVI of overall manual was 0.75.Conclusions: The responsibilities of care and management were on the home-based patients withCOPD and their families. The home-based COPD patients need to be further strengthened in cognitionof disease, correct use of medication, self-management of symptoms, breathing skills, exercise trainingand psychological stress adjustment. We hope that the PR manual will enhance the ability of home-basedpatients with COPD to perform pulmonary rehabilitation, and improve their quality of life.