摘要
目的探讨不愉快症状及其前置因素对慢性阻塞性肺疾病患者功能状态的影响。方法采用便利抽样法, 选取2020年1月-2023年6月新乡市中心医院呼吸与危重症医学科收治的慢性阻塞性肺疾病患者为研究对象。采用一般资料调查表、功能状况问卷简表(FPI-SF)、记忆症状评估量表(MSAS)、Mishel疾病不确定感量表(MUIS)、社会支持评定量表(SSRS)和一般自我效能感量表(GSES)对研究对象进行调查。采用GOLD分级评估研究对象的肺功能。采用Pearson相关分析探讨FPI-SF、MSAS、MUIS、SSRS、GSES得分及GOLD分级之间的相关性。采用结构方程模型探讨不愉快症状及其前置因素对慢性阻塞性肺疾病患者功能状态的影响。结果共发放问卷279份, 回收有效问卷276份, 问卷有效回收率为98.92%。276例慢性阻塞性肺疾病患者的FPI-SF得分为(66.63±7.68)分、MSAS得分为(66.59±8.85)分、MUIS得分为(95.41±12.83)分、SSRS得分为(43.94±5.94)分、GSES得分为(23.78±4.88)分。功能状态与不愉快症状、疾病不确定感、GOLD分级呈负相关(r值分别为-0.478、-0.353、-0.574, P<0.05);与社会支持、自我效能感呈正相关(r值分别为0.451、0.364, P<0.05)。结构方程模型显示, GOLD分级、疾病不确定感和社会支持可通过不愉快症状间接影响功能状态;GOLD分级和社会支持可直接影响功能状态;自我效能感在不愉快症状与功能状态之间起部分中介作用(P<0.05)。结论慢性阻塞性肺疾病患者的功能状态水平较差, 医护人员可从生理、心理、社会环境和自我效能感等方面制订综合干预措施以提高患者的功能状态。
Objective To explore the impact of unpleasant symptoms and their antecedents on the functional performance of patients with chronic obstructive pulmonary disease(COPD).Methods From January 2020 to June 2023,convenience sampling was used to select COPD patients admitted to the Respiratory and Intensive Care Unit of Xinxiang Central Hospital as research subjects.The subjects were surveyed using the General Information Questionnaire,Functional Performance Inventory-Short Form(FPI-SF),Memory Symptom Assessment Scale(MSAS),Mishel Uncertainty in Ilness Scale(MUIS),Social Support Rating Scale(SSRS),and the General Self-Efficacy Scale(GSES).Global Initiative for Chronic Obstructive Lung Disease(GOLD)grading was used to evaluate subjects'lung function.Pearson correlation was used to explore the correlation between the scores FPI-SF,MSAS,MUIS,SSRS,GSES,and GOLD grading.Structural equation modeling was implemented to explore the impact of unpleasant symptoms and their antecedents on the functional performance of COPD patients.Results A total of 279 questionnaires were distributed and 276 valid questionnaires were collected,with a valid response rate of 98.92%.Among 276 COPD patients,the scores of FPI-SF,MSAS,MUIS,SSRS,and GSES were(2.08±0.24),(2.08±0.28),(95.41±12.83),(43.94±5.94),and(23.78±4.88),respectively.Functional performance was negatively correlated with unpleasant symptoms,disease uncertainty,and GOLD grading(r=-0.478,-0.353,-0.574;P<0.05)and positively correlated with social support and self-efficacy(r=0.451,0.364;P<0.05).Structural equation modeling showed that GOLD grading,disease uncertainty,and social support indirectly affected functional performance through unpleasant symptoms,while GOLD grading and social support directly affected functional performance,and self-efficacy played a partial mediating role between unpleasant symptoms and functional performance;the above differences were statistically significant(P<0.05).Conclusions The functional performance of COPD patients is poor.Medical and nursing staff can develop comprehensive intervention measures,including physiology,psychology,social environment,and self-efficacy,to improve patients'functional performance.
作者
乔红伟
程旭
许鑫铭
Qiao Hongwei;Cheng Xu;Xu Xinming(Respiratory and Intensive Care Unit,Xinxiang Central Hospital(the Fourth Clinical College of Xinxiang Medical University),Xinxiang 453000,China)
出处
《中华现代护理杂志》
2024年第27期3738-3744,共7页
Chinese Journal of Modern Nursing
基金
2021年度河南省医学科技攻关计划联合共建项目(LHGJ20210898)。
关键词
肺疾病
慢性阻塞性
不愉快症状理论
功能状态
结构方程模型
Pulmonary disease,chronic obstructive
Theory of unpleasant symptoms
Functional performance
Structural equation modeling
