Abstract: Objective: To explore the effects of applying 4R crisis management theory to the 6 Minutes Walking Test (6MWT) management of patients with Connective Tissue Disease associated Pulmonary Arterial Hypertension (CTD-PAH). Methods: Totally 120 patients with CTD-PAH in the Department of Immunology of Peking Union Medical College Hospital from January to December 2022 were enrolled and divided into two groups. The control group was given the routine care of the 6 Minutes Walking Test (6MWT) while the experimental group received the updated care during the 6MWT based on the 4R crisis management theory. The differences of blood oxygen saturation and the occurrence of adverse events after the walking test between the two groups were analyzed. Results: As to the walking distance of patients, no significant differences between the two groups were observed. The blood oxygen saturation of the experimental group was significantly higher than that of the control group after the 6MWT and 3 minutes after the test. The incidence of hypoxia and adverse events during the 6MWT in the experimental group was significantly lower than that in the control group. Conclusion: Care based on the 4R crisis management during the 6MWT can significantly reduce the incidence of hypoxia and adverse reactions in patients with CTD-PAH, greatly ensuring the safety of those patients.

Key words: 4R crisis management; connective tissue disease; pulmonary arterial hypertension; 6 Minutes Walking Test; management process