Abstract:

Objective　To investigate the effect of cognitive-behavioural intervention on elderly patients with chronic obstructive pulmonary disease (COPD) complicated with cognitive decline. Methods　A total of 120 COPD patients with cognitive decline who were treated in Henan Provincial People's Hospital from March 2021 to March 2022 were simply randomly divided into a control group (60 cases) and an observation group (60 cases). In the control group, there were 38 males and 22 females, aged 60-78 (69.25±4.19) years, the course of disease was 1-15 (8.00±1.53) years, and the lung function grading was grade Ⅱ in 35 cases and grade Ⅲ in 25 cases. In the observation group, there were 40 males and 20 females, aged 60-78 (69.58±4.00) years, the course of disease was 1-15 (8.15±1.40) years, and the lung function grading was grade Ⅱ in 38 cases and grade Ⅲ in 22 cases. The control group received routine nursing intervention, and the observation group received cognitive-behavioral intervention on the basis of the control group. After discharge, both groups were intervened for 6 months by outpatient visit or telephone follow-up and were followed up for 1 year. The differences in frailty level, cognitive function score, self-care ability, and quality of life score were compared between the two groups. t test was used for the measurement data and χ² test was used for the count data. Results　After 6 months and 1 year, the frailty scores in the observation group were (2.57±0.11) points and (2.00±0.18) points, which were lower than those in the control group [(3.00±0.15) points and (2.71±0.20) points] (t=17.906 and 20.439, both P<0.05); the cognitive function scores in the observation group were (22.68±1.05) points and (25.69±1.20) points, which were higher than those in the control group [(20.36±1.00) points and (23.18±1.11) points] (t=12.394 and 11.894, both P<0.05); the scores of self-care ability in the observation group were (83.15±5.28) points and (88.63±6.47) points, which were higher than those in the control group [(75.26±4.16) points and (80.23±5.18) points] (t=9.092 and 7.581, both P<0.05); the quality of life scores in the observation group were (45.60±3.09) points and (40.23±2.69) points, which were lower than those in the control group [(50.18±4.00) points and (45.18±3.15) points] (t=7.019 and 9.256, both P<0.05). Conclusion　Cognitive-behavioural intervention can effectively delay the cognitive decline process of elderly patients with COPD and cognitive decline, improve their cognitive function and quality of life, and enhance their self-care ability.

Key words:

Chronic obstructive pulmonary disease, Cognitive decline, Elderly, Cognitive-behavioural therapy, Cognitive function

摘要：

目的　探究认知行为干预在老年慢性阻塞性肺疾病（COPD）合并认知衰弱患者中的应用效果。方法　选取2021年3月至2022年3月在河南省人民医院就诊的COPD合并认知衰弱患者120例，简单随机分为对照组（60例）和观察组（60例）。对照组男38例，女22例，年龄60～78（69.25±4.19）岁，病程1～15（8.00±1.53）年，肺功能分级：Ⅱ级35例，Ⅲ级25例。观察组男40例，女20例，年龄60～78（69.58±4.00）岁，病程1～15（8.15±1.40）年，肺功能分级：Ⅱ级38例，Ⅲ级22例。对照组予以常规护理干预，观察组在对照组基础上予以认知行为干预。患者出院后，通过门诊复诊或电话随访持续对其干预6个月，并进行为期1年的随访。比较两组衰弱水平、认知功能评分、自护能力以及生活质量评分。计量资料用t检验，计数资料用χ²检验。结果　干预6个月后、1年后，观察组衰弱评分分别为（2.57±0.11）分、（2.00±0.18）分，低于对照组的（3.00±0.15）分、（2.71±0.20）分（t=17.906、20.439，均P<0.05）；观察组认知功能评分分别为（22.68±1.05）分、（25.69±1.20）分，高于对照组的（20.36±1.00）分、（23.18±1.11）分（t=12.394、11.894，均P<0.05）；观察组自护能力评分分别为（83.15±5.28）分、（88.63±6.47）分，高于对照组的（75.26±4.16）分、（80.23±5.18）分（t=9.092、7.581，均P<0.05）；观察组生活质量评分分别为（45.60±3.09）分、（40.23±2.69）分，低于对照组的（50.18±4.00）分、（45.18±3.15）分（t=7.019、9.256，均P<0.05）。结论　认知行为干预能够有效延缓老年COPD合并认知衰弱患者的认知衰弱进程，改善其认知功能与生活质量，提高其自护能力。

关键词:

慢性阻塞性肺疾病, 认知衰弱, 老年, 认知行为疗法, 认知功能