The Research On Relationship Among Meaning In Life,Anxiety-Depression And Exercise Self-Efficacy In Patients With Chronic Obstructive Pulmonary Disease

ObjectiveTo assess the correlation between the meaning in life,anxiety-depression and exercise self-efficacy of COPD patients through investigating the current status of the three items.And to analyze the influencing factors of exercise self-efficacy in COPD patients.At the same time,we explored the true experience of COPD patients’ sense of life.It is expected to provide a reference basis for promoting COPD patients to establish better psychological coping styles,improve quality of life,reduce negative emotions such as anxiety and depression,improve their meaning in Life and carry rehabilitation exercise.MethodThis research is a non-experimental study,we collected data by questionnaire survey and semi-structured interview.A total of 154 COPD patients were selected from 3hospitals in Qingdao from May 2018 to March 2019 as the survey object.The general information questionnaire,Meaning in Life Questionnaire,Hospital Anxiety and Depression Scale and Exercise Self-Regulatory Efficacy Scale were used to investigate the status of the COPD patients’ meaning in life,anxiety-depression and exercise self-efficacy and analyze the relationship among them.Data were recorded,sorted and analyzed using Epidata3.1 and SPSS 22.0 software.Descriptive statistical analysis,independent sample t-test,univariate analysis,Pearson correlation,and multiple stepwise regression analysis were adopted for data analyses.Sixteen COPD patients who had participated in the pre-survey from June 2018 to November 2018 were selected as the interview subjects using the purposive sampling.Colaizzi7-step analysis method was used to analyze the contents of semi-structured to determine the theme and supplement the results of the questionnaire survey.Result1.The average score of COPD patients’ meaning in life was(43.31±6.82),the score of meaning in life of presence was(25.30±4.32),and the score of meaning in life of search was(18.01±3.11);The anxiety score of COPD patients was(7.12±2.98),and the depression score was(6.31±3.74);the average score of exercise self-efficacy was(63.85±16.22).Correlation analysis showed that the meaning in life of COPD patients was negatively correlated with anxiety and depression(r=-0.657,r=-0.530,P<0.01),and positively correlated with exercise self-efficacy(r=0.589,P<0.01);Exercise self-efficacy of COPD patients was positively correlated with anxiety(r=0.511,P<0.01)and negatively correlated with depression(r=-0.572,P<0.01).Multiple stepwise regression analysis showed that age,education level,lung function grade,payment manner of the medical expenses,meaning in life,anxiety and depression are the influencing factors of exercise self-efficacy in COPD patients,and jointly explain 53.10% of the total variation of exercise self-efficacy score.2.Five themes were extracted from COPD patients’ perception of the meaning in life:theme 1: changes in survival consciousness(anxiety-depression,loss and crisis);theme 2:understanding of one’s own existence(relationship,hope,responsibility);theme 3:perception of self-realization(dedication,self-adjustment);theme 4: treatment and health behavior perspective(negative attitude,positive psychology);theme 5: death cognition and attitude(face to death,fear process).Conclusion1.The meaning in life and exercise self-efficacy of COPD patients are at medium level,and COPD patients have certain anxiety and depression symptoms.There was a correlation among meaning in life,anxiety-depression and exercise self-efficacy in COPD patients.The level of exercise self-efficacy of COPD patients was affected by age,education level,lung function classification,payment manner of the medical expenses,meaning in life,anxiety and depression.2.COPD patients’ perception of life in meaning can affect their emotions and exercise behaviors.A better sense of meaning in life can reduce patients’ negative emotions such as anxiety and depression,stimulate their intrinsic motivation for health promotion,and promote COPD patients to acquire healthy behaviors.Clinical nurses should take effective measures to promote the healthy development of the psychological and behavior of COPD patients,increase the level of patients’ meaning in life,and promote the improvement of their exercise self-efficacy,so as to encourage patients toacquire health behaviors and achieve better physical and mental rehabilitation.