A Study On The Present Situation And Influencing Factors Of Activation Degree Of Patients With Chronic Obstructive Pulmonary Disease In A Region Of Hunan Province

ObjectiveTo understand the current situation of COPD patients’activition in a certain area of Hunan Province,and analyze the influencing factors of COPD patients’activition,so as to provide reference for medical staff to formulate effective intervention measures and improve COPD patients’activition level.MethodsThis study adopts the method of combining quantitative research with qualitative research.The quantitative study used cluster sampling method,From July 2020 to October 2020,a total of 329 patients with COPD who were admitted to the Department of Respiratory Medicine in 2 tertiary hospitals in a certain area of Hunan Province and met the inclusion and exclusion criteria were selected.COPD patients were investigated by self-designed general information questionnaire,patient activation measure,the brief illness perception questionnaire and social support rating scale.The collected data were recorded into Excel software by two people,and then imported into SPSS 22.0 software for statistical analysis,including descriptive statistics,t-test,analysis of variance,nonparametric test,Spearman and Pearson correlation analysis and multiple linear stepwise regression analysis,etc.In qualitative study,12 COPD patients with low activition score were selected for semi-structured in-depth interviews using objective sampling method,and the data were analyzed by Colaizzi seven-step analysis method,to deeply understand the inner experience of COPD patients’self-health management activition,and to further explore the influencing factors of COPD patients’activition.Results1.In this study,the total score of 329 COPD patients’positivity scale(percentage scale)ranged from 32.2 to 70.6 points,The total average score was(50.26±7.06).2.Univariate analysis results showed that different age,education level,occupation,long-term residence,family per capita monthly income,smoking status,disease course,the number of hospitalizations due to COPD in the last year,and the degree of dyspnea had significant effects on the positive degree of COPD patients(P<0.05).3.Spearman correlation analysis showed that the total positive score of COPD patients was negatively correlated with the total disease perception score(P<0.05);Pearson correlation analysis showed that total positive score of COPD patients was positively correlated with total social support score(P<0.05).4.The results of multiple linear stepwise regression analysis show that:social support,disease perception,education level,disease course,occupation,long-term residence,degree of breathing difficulties,age were the influencing factors of COPD patients’activition.F=27.426,P<0.001,indicating that the fitted equation had statistical significance,and the determination coefficient R~2=0.407,indicating that the independent variable could explain 40.7%variation in patients’activition.5.Qualitative findings:According to the inner experience of COPD patients’activition in self-health management,the hindrance factors of COPD patients’activition were extracted as follows:(1)Topic 1.Personal factors:(1)Physiological decline;(2)Lack of awareness of disease;(2)Topic II.Disease factors:(1)Trouble of disease symptoms;(3)Theme three,drug factors:(1)Worry about the adverse reactions of long-term drug use;(2)Drug resistance;(3)Lack of knowledge about drugs;(4)Topic IV.Psychosocial factors:(1)Worried about the prognosis of the disease;(2)Negative emotions;(3)Guilt towards family members;(4)Economic difficulties Conclusions1.The overall positive degree of COPD patients is at the second level,which needs to be further improved.2.Social support,disease perception,education level,disease course,occupation,long-term residence,degree of dyspnea and age were the main influencing factors of COPD patients’activition.3.Through qualitative research,the obstructive factors of COPD patients with positive degrees have personal factors(physiological function decline,lack of understanding of the disease),disease factors(symptoms),drug factors(worried about long-term drug adverse reactions,drug resistance,lack of relevant knowledge of drugs)and psychosocial factors(worries about disease prognosis,negative emotions,guilt,economy trapped for their family Difficult).