Study On The Influence Of Social Participation On Self-Management And Mediating Effect In Elderly Patients With COPD

ObjectiveFirst of all,the purpose of this study is to investigate the current situation of social participation,selfefficacy,coping style and self-management in elderly patients with chronic obstructive pulmonary disease(COPD),to explore the influence mechanism of social participation on self-management in elderly patients with COPD,and to analyze the mediating effect of self-efficacy between social participation and selfmanagement in elderly COPD patients,and the moderating effect of coping style on self-efficacy.Thus to help improve the self-management level of elderly patients with COPD and formulate the corresponding intervention program to provide a theoretical basis.MethodsIn this study,convenient sampling was used to recruit elderly patients with stable COPD who met the inclusion and exclusion criteria in five communities in Kaifeng City,Henan Province from December 2021 to July 2022.Using general data questionnaire(demographic data and disease data),COPD patients’ selfmanagement ability scale(COPD-SMS),self-participation questionnaire(IPA),chronic disease selfefficacy scale(CDSES),simplified coping style scale(SCSQ)as research tools,a total of 324 questionnaires were distributed,314 were effectively recovered,and the effective recovery rate was 95%.Epidata3.1 is used for data input,SPSS26.0 software and Process macro program for data statistical analysis.Statistical methods include descriptive analysis,one-way ANOVA,t-test,Tukey method,GamesHowell method,Pearson correlation analysis,multiple linear regression analysis,stepwise test regression coefficient method and Bootstrap test.Results1.Descriptive analysis: Social participation score of elderly COPD patients was(37.79±15.86)points;the score of self-management in elderly COPD patients was(149.01±31.22)points;The positive coping style items of the elderly COPD patients were scored(1.81±0.18)points,and the negative coping style items were scored(1.56±0.18)points.The score of self-efficacy(CDSES)in elderly COPD patients was8.80±1.58.2.Univariate analysis: There were significant differences in social participation scores of elderly COPD patients with different age,educational level,living style,course of disease and whether there were complications(P<0.05).There were significant differences in self-management scores among elderly COPD patients with different education level,residence,per capita monthly income,previous occupation,number of hospitalizations due to the disease and whether there were complications.There were significant differences in self-efficacy scores among the aged COPD patients with different gender,education level,living style,residence and course of disease(P<0.05).There were significant differences in the scores of active coping styles among the elderly COPD patients with different age,education level,marital status,course of disease and number of hospitalizations due to the disease(P<0.05),and there were significant differences in the scores of active coping styles among the elderly COPD patients with different gender,age,living style,per capita monthly income and whether there were complications(<0.05).3.The results of correlation analysis showed that social participation was positively correlated with self-efficacy,positive coping style and self-management(r=0.703,P<0.01;r=0.724,P<0.01;r=0.597,P<0.01),was significantly negatively correlated with negative coping style(r=-0.600,P<0.01).Self-efficacy was positively correlated with positive coping style and self-management(r=0.734,P<0.01;r=0.587,P <0.01),was significantly negatively correlated with negative coping style(r=-0.545,P< 0.01).There was a significant positive correlation between positive coping style and self-management(r=0.635,P< 0.01),and a significant negative correlation between negative coping style and negative coping style(r=-0.573,P<0.01).There was a significant negative correlation between negative coping style and self-management(r=-0.466,P < 0.01).4.Multi-factor analysis showed that social participation,educational level,self-efficacy,positive coping style and negative coping style were the main influencing factors of self-management in elderly patients(P < 0.05).5.The results of moderated mediation test showed that coping style played a partial mediating role between social participation and self-management in elderly COPD patients(-0.141),accounting for33.27% of the total effect;at the same time,self-efficacy played a regulatory role in the latter half of the mediating role of coping style.ConclusionsThe social participation,self-efficacy,coping style and self-management of the elderly patients with COPD were at medium level.Social participation,self-efficacy,coping style and self-management are closely related.In addition,social participation in senile COPD patients is affected by a variety of factors.Self-efficacy plays a partial mediating role between social participation and self-management in senile COPD patients,and coping style plays a moderating role in the mediating role of self-efficacy.Therefore,attention should be paid to improving the level of social participation and self-efficacy of patients,promoting them to adopt positive coping styles,and ultimately improving the level of self-management of patients...