Effect Of Discharge Readiness On Quality Of Life Of Elderly Patients With COPD And Mediating Effect Analysis

ObjectiveTo investigate and analyze the state and influence factors of discharge readiness and quality of life of elderly patients with chronic obstructive pulmonary disease(COPD);to explore the correlation between discharge readiness,self-efficacy,self-management ability and quality of life;to construct mediating effect model and to explore the mediating effect of self-efficacy and self-management ability between discharge readiness and quality of life.This study aims to provide a theoretical basis for formulating targeted intervention measures and improving the quality of life of elderly COPD patients.Methods1.Convenience sampling method was utilized to select 246 elderly patients with COPD who met the inclusion and exclusion criteria of the study from December 2020 to September 2021,in a third-level hospital in Kaifeng City.The research tools include: general information questionnaire,Readiness for Hospital Discharge Scale(RHDS),Chronic Disease Self-Efficacy Scale(CDSES),COPD Self-Management Scale(COPD-SMS),and COPD Assessment Test(CAT).2.The database was established using Epidata 3.1,and SPSS 25.0 software was used for data analysis.General data were described by frequency,percentage,mean and standard deviation.Independent sample ttest,one-way ANOVA and multiple linear regression analysis were utilized to compare the differences of discharge readiness and quality of life.Pearson correlation analysis was utilized to analyze the correlation between discharge readiness,self-efficacy,self-management ability and quality of life.Process plugin was utilized to explore the mediating effect of self-efficacy and self-management ability between discharge readiness and quality of life.Results1.The total score of RHDS of elderly COPD patients is(75.57±10.42),the dimension of personal status score is(21.0±3.60),the dimension of adaptability score is(31.65±5.63),and the dimension of excepted support score is(22.92±3.59).There are statistically significant differences in RHDS of patients with different modified British Medical Research Council dyspnea score(m MRC),age,marital status and current residence.2.The total score of CAT in elderly patients with COPD is(13.96±7.50).There are significant differences in CAT of patients with different m MRC score,other drug types,course of disease,age,number of complications and marital status.3.The total score of CDSES elderly patients with COPD is(28.20±7.38),and the standardized score is(4.70 ± 1.23).The total score of COPD-SMS of elderly patients with COPD is(159.28 ± 12.87),and the standardized score is(3.12 ± 0.25).4.Pearson correlation analysis showed that elderly COPD patients’ discharge readiness score is positively correlated with self-efficacy score(r = 0.710,P < 0.01),positively correlated with selfmanagement ability score(r = 0.500,P < 0.01),and negatively correlated with quality-of-life score(r =-0.747,P < 0.01).The quality-of-life score is negatively correlated with self-efficacy score(r =-0.699,P <0.01),and negatively correlated with self-management ability score(r =-0.604,P < 0.01).Pearson correlation analysis showed that discharge readiness of elderly COPD patients is positively correlated with self-efficacy(r=0.810,P<0.01),and is positively correlated with self-management ability(r=0.500,P<0.01),and is negatively correlated with CAT total score(r=-0.847,P<0.01).The CAT total score is negatively correlated with CDSES total score(r=-0.799,P<0.01),and is negatively correlated with COPD-SMS total score(r=-0.604,P<0.01).5.The results of mediating effect analysis show that self-efficacy plays partial mediating role between discharge readiness and quality of life in elderly COPD patients,accounting for 31.48% of total effect;selfmanagement ability plays partial mediating role between discharge readiness and quality of life,accounting for 14.26% of total effect.The chain mediating effect value of self-efficacy and self-management ability between discharge readiness and quality of life is-0.018,the chain mediating effect is significant,and the total indirect effect accounts for 50.73% of the total effect.Conclusion1.Elderly COPD patients’ discharge readiness is at a low level.m MRC score,age,marital status,current residence,and medical payment are the main factors affecting discharge readiness of elderly patients with COPD.2.Elderly COPD patients’ quality of life is at a medium level.m MRC score,other drug types,course of disease,age,number of complications and marital status are the main factors affecting the quality of life of elderly patients with COPD.3.Elderly COPD patients’ self-efficacy is at a medium level,and the self-management ability is at a medium level.4.There is a significant correlation between discharge readiness,quality of life,self-efficacy,and selfmanagement ability in elderly COPD patients.The higher the discharge readiness,self-efficacy and selfmanagement ability of elderly COPD patients,the better the quality of life.5.Elderly COPD patients’ self-efficacy plays a partial mediating role between discharge readiness and quality of life;Self-management ability plays a partial mediating role between discharge readiness and quality of life;Self efficacy and self-management ability play a chain mediating role between discharge readiness and quality of life.