Study On The Status And Their Action Path Of Influencing Factors Of Subjective Well-Being Among Patients With Chronic Obstructive Pulmonary Disease

ObjectiveThe purpose of this study is to investigate the status quo of subjective well-being of patients with chronic obstructive pulmonary disease(COPD),analyze the influencing factors of subjective well-being of patients with COPD,and explore the action path and action effect of each factor on the subjective well-being of subjects,so as to provide a reference for formulating relevant measures to improve the subjective well-being of patients with COPD in the future.MethodsFrom December 2021 to November 2022,265 COPD patients in the outpatient department and inpatient department of Respiratory and critical care Medicine in two grade III Class A hospitals in Lanzhou were selected by convenience sampling method.General information questionnaire,Memorial University of Newfoundland Happiness Scale,Perceived Social Support Scale,Sense of Coherence-13 scale and Medical Coping Modes Questionnaire were used to investigate the status and influencing factors of subjective well-being.Frequency,constituent ratio,mean±standard deviation were used to describe the general information of the subjects and the scores of the research variables;One-way ANOVA analysis of variance or independent sample t test was used to analyze whether there were differences in subjective well-being of COPD patients with different demographic characteristics;Pearson correlation analysis was used to analyze the subjective well-being of COPD patients and the correlation between the influencing factors;Multiple linear stepwise regres sion was used to analyze the influencing factors of subjective well-being of COPD patients.SPSS26.0 software was used for statistical analysis of the data.AMOS24.0 software was used to construct the structural equation model of influencing factors of subjective well-being of COPD patients,to clarify the action path of influencing factors of subjective well-being of COPD patients,and to analyze the path coefficient of influencing factors.To explore the effect of each influencing factor of subjective well-being of COPD patients,and test and verify the multiple mediating effect in the model by Bootstrap method in AMOS24.0 software.P<0.05 was considered statisticallysignificant in all the above test criteria.Results1.The total score of subjective well-being of COPD patients was(25.27±10.06),among which the scores of positive affect,positive experience,negative affect and negative experience were(5.78±2.93),(7.04±3.17),(4.53±2.99)and(7.02±3.54),respectively.According to the relevant scoring standards of the scale,among 265 COPD patients,27(10.8%)had a low level of subjective well-being,178(71.2%)had a medium level,and 45(18.0%)had a high level of subjective well-being.2.Results of One-way ANOVA analysis:there were statistically significant differences in the level of subjective well-being in COPD patients with different ages,religious beliefs,educational levels,occupational status,family per capita monthly income,course of disease,number of comorbidities,and severity of dyspnea(P<0.05).3.Results of Multiple linear regression analysis:age,family support,meaningfulness,sense of control,number of comorbidities,friend support,facing and avoidance entered the regression equation,and the above 8 variables were the main factors affecting the subjective well-being of COPD patients(P<0.001),which could explain 62.8%of the variation(R~2=0.628).4.Results of Pearson correlation analysis:the total score of subjective well-being of COPD patients was positively correlated with the total score of sense of coherence,facing coping style and social support(P<0.01),and the correlation coefficients were r=0.574,0.619 and 0.560,respectively;it is negatively correlated with the total scores of avoidance and yielding coping styles(P<0.01),and the correlation coefficients are r=-0.451 and-0.515,respectively.5.Results of Path analysis results of structural equation model:(1)Path 1:Sense of coherence→subjective well-being:sense of coherence has a direct positive effect on subjective well-being of COPD patients,and the path coefficient isβ=0.250(P<0.01).(2)Path 2:Facing→subjective well-being:facing coping style has a direct positive effect on subjective well-being of COPD patients,and the path coefficient isβ=0.263(P<0.001).(3)Path 3:Avoidance→subjective well-being:avoidance coping style has a direct negative effect on subjective well-being of COPD patients,and the path coefficient isβ=-0.240(P<0.001).(4)Path 4:Social support→subjective well-being:social support has a direct positive effect on subjective well-being of COPD patients,and the path coefficient isβ=0.415(P<0.001).(5)Path 5:Social support→sense of coherence→subjective well-being:social support can also indirectly affect the subjective well-being of COPD patients through sense of coherence,and the indirect effect value is 0.173.(6)Path 6:Social support→facing→subjective well-being:social support can also indirectly affect the subjective well-being of COPD patients through facing coping style,and the indirect effect value is 0.148.(7)Path 7:Social support→avoidance→subjective well-being:social support can also indirectly affect the subjective well-being of COPD patients through avoidance coping style,and the indirect effect value is 0.100.Conclusions1.The subjective well-being of COPD patients is at a medium level,and the level of subjective well-being of this group needs to be further improved.2.Age,religious belief,education level,occupational status,family per capita monthly income,course of disease,quantity and severity of dyspnea are the influencing factors of subjective well-being.3.Sense of coherence and facing coping style have a direct positive predictive effect on subjective well-being of COPD patients;avoidance coping style has a direct negative predictive effect on subjective well-being of COPD patients;social support can not only directly positively affect SWB,but also indirectly positively affect SWB through sense of coherence,facing coping style and avoidance coping style,and the indirect effect is greater than the direct effect.It is suggested that in the future nursing work,we should pay more attention to the level of subjective well-being of COPD patients,integrate general demographic and disease-related characteristics,and consider encouraging patients to play a subjective active role to maintain mental health status;create a harmonious family atmosphere,optimize the patient’s family function;accurately locate the types of coping styles,encourage patients to actively face them,and attach importance to individual internal coping resources;establish and improve the security system,give play to the role of social support and other levels to comprehensively formulate scientific,reasonable,personalized,systematic and comprehensive intervention measures to improve the subjective well-being of COPD patients,and finally improve the subjective well-being level of COPD patients.