The Study On The Relative Factors Of Symptom Experience In Elderly With Chronic Obstructive Pulmonary Disease

ObjectiveTo describe the symptom experience of the elderly with Chronic Obstructive Pulmonary Disease(frequency,severity and distress),explore the relationship with self-efficacy,self-care behaviors,Hospital Anxiety and Depression and to analysis the influencing factors of symptom experience of the elderly with COPD.The goal of symptom management is to reduce frequency,minimize severity,and relieve distress.To be able to identify and overcome barriers to providing needed symptom management to these patients and their families,which enhance the quality of life.MethodsWe examined 255 consecutive patients at the lung function laboratory,respiratory clinic and ward in Zhengzhou hospital,form December in 2015 to August in 2016.All patients received treatment in hospital.Collected data on basic information questionnaire and clinical characteristics,Memorial Symptom Assessment,self-efficacy,Hospital Anxiety and Depression in target population.All data were analyzed by Epidata3.1 and SPSS17.0.By descriptive analysis method,One-way analysis,Pearson correlation analysis,Multivariate linear regression analysis for data analysis.Analyze the related factors affecting patients experience symptoms.Results1.Totally 255 patients meeting the inclusion criteria were investigated,only 240 questionnaires were collected,so the effective collect rate was 94.1%.2.Mainly happened symptoms in the older adults with COPD included shortness of breath(97.5%),lack of energy(95.4%),worrying(82.1%),cough(80.4%),difficulty sleeping(72.1%),pain(68.8%),feel sad(64.6%),I don't look like myself(53.3%).The highest mean MSAS-PHYS was(3.89±2.06),MSAS-PSYCH was(2.04±1.08),MSAS-GDI was(1.67±0.67),TMSAS was(2.20±0.90).In MSAS supplemented entries,some patients appear chest tightness,coughing of phlegm symptoms.At the same time,also bring to more burden.3.The mean score of self-efficacy was(4.47±1.19),generally was in medium and low level.There were two dimensions including symptom management self-efficacy which's score was(5.32±1.71)and disease common management self-efficacy which's score was(5.42±1.79).Most of patients was low level(58.75%),only 3.75% was at high level.240 consecutive patient self-care behavior was(81.76±16.82),the highest was 121,the lowest was 23,only 3.34% was at high level.4.The result of the Pearson correlation analysis revealed that there exists the negative correlation between the symptom experience and self-care behavior(r=-0.233,P?0.01),self-efficacy((r=-0.226,P?0.01).positive correlation with anxiety and depression r(r=0.496,P?0.01).5.The influencing factors of symptom experience were education,Survey source,prior to the professional,the way of treatment cost,Smoking,Stage of disease,Lung function,Family income,Residence(P?0.05).6.Multiple linear regression analysis results showed that the influence factors affecting the symptom experience of the older adults with COPD were staging of disease,self-efficacy,the way of treatment cost and HADS total score,the four variables explained 40.2% of the variance of the level of symptom.Conclusions1.There were high burden with patients,Highly prevalent symptoms(?50% of the total sample)were shortness of breath(97.5%),lack of energy(95.4%),worrying(82.1%),cough(80.4%),difficulty sleeping(72.1%),pain(68.8%),feel sad(64.6%),I don't look like myself(53.3%).2.The result of the Pearson correlation analysis revealed that there exists the negative correlation between the symptom experience and self-care behavior,self-efficacy.Positive correlation with anxiety and depression.3.The influencing factors of symptom experience of the elderly patients with COPD were staging of disease,work before disease,the way of treatment cost and HADS total score.While what influenced the symptom experience were AECOPD,farmer,low level of economic.To better understand the burden of illness associated with COPD,In order to improve their quality of life and satisfy their diversified service needs,the particularity of the influences should be considered,and the specific measures should be made,when we establish and improve the symptom management system.