老年肺结核合并慢性阻塞性肺疾病患者正念水平与自我感受负担及预后的关系研究

Mindfulness Level and Its Correlation with Self- perceived Burden and Prognosis in Aged Tuberculosis Patients Complicated with Chronic Obstructive Pulmonary Disease

目的探讨老年肺结核合并慢性阻塞性肺疾病(COPD)患者正念水平与自我感受负担(SPB)及预后的关系。方法选择2013年10月—2014年10月在唐山市人民医院住院治疗的老年肺结核合并COPD患者148例,征得患者同意后进行一对一现场调查。内容包括一般资料采集、正念水平、SPB评分及用药依从性,观察患者治疗2个月后预后。结果根据正念注意觉知量表(MAAS)评分将148例患者分为高水平组75例和低水平组73例,高水平组患者治疗有效率为84.0%,高于低水平组的60.3%(χ2=16.25,P=0.001)。多因素Logistic回归分析结果显示,正念水平〔β=-0.268,OR=0.62,95%CI(0.404,0.788)〕、SPB评分〔β=0.322,OR=1.96,95%CI(1.115,3.826)〕及用药依从性〔β=0.412,OR=2.64,95%CI(1.666,5.248)〕是老年肺结核合并COPD患者预后的影响因素。Pearson相关分析结果显示,正念水平与SPB评分呈负相关(r=-0.639,P<0.01);SPB评分与用药依从性呈负相关(r=-0.618,P<0.01)。结论高水平正念可在一定程度上减轻老年肺结核合并COPD患者的SPB,有利于改善患者预后。

Objective To investigate the mindfulness level and its correlation with self -perceived burden （ SPB ） and prognosis in aged tuberculosis patients complicated with chronic obstructive pulmonary disease（ COPD）. Methods A total of 148 aged tuberculosis patients complicated with COPD were selected in the People′s Hospital of Tangshan from October 2013 to October 2014,and one -to -one field investigation was carried out after patients′consent. General information,mindfulness level,SPB score, medication compliance, prognosis after 2 months of treatment were collected and observed. Results According to MAAS score,all of the patients were divided into groups A（with high mindfulness level,n=75）and B（with low mindfulness level,n=73）,the effective rate of A group was 84. 0%,was higher than that of B group of 60. 3%（χ2 =16. 25,P=0. 001）. Multivariable Logistic regression analysis showed that,mindfulness level〔β = -0. 268,OR =0. 62, 95%CI（0. 404,0. 788）〕,SPB score〔β=0. 322,OR=1. 96,95%CI（1. 115,3. 826）〕and medication compliance〔β=0.412,OR = 2.64,95% CI（1.666,5.248）〕were influencing factors of prognosis of aged tuberculosis patients complicated with COPD. Pearson correlation analysis showed that,mindfulness level was negatively correlated with SPB score, SPB score was negatively correlated with medication compliance（r = -0. 618,P 〈0. 01）. Conclusion High mindfulness level can reduce the SPB of aged tuberculosis patients complicated with COPD to some extent,is helpful to improve the patients′prognosis.