急性加重期COPD患者自我感受负担与应对方式的相关性研究

Relationship between self-perceived burden and coping style in patients with acute exacerbation of chronic obstructive pulmonary disease

目的调查慢性阻塞性肺疾病急性加重期（AECOPD）患者的自我感受负担（SPB）和医学应对方式的情况，并分析两者间的相关性及患者SPB的影响因素。方法2014年12月—2015年5月，采用一般情况调查表、中文版自我感受负担量表（SPBS）和医学应对问卷（MCMQ）对大庆市人民医院和油田总医院呼吸内科住院的183例AECOPD患者进行调查，并采用Pearson相关分析法、单因素方差分析及多元线性回归分析探讨两者之间的相关性及SPB的影响因素。结果AECOPD患者SPBS总分为（35．13±6．69）分，处于中度水平；医学应对方式总分均分为（42．96±4．28）分，面对、回避和屈服各维度得分与国内常模比较差异有统计学意义（P〈0．05）。患者SPBS得分与面对应对方式得分和回避应对方式得分呈负相关（r值分别为-0．41，-0．31；P〈0．01）；与屈服应对方式得分呈正相关（r=0．49，P〈0．01）。多元线性回归分析显示，患者SPB的影响因素有文化程度、家庭人均月收入、医保方式、自我效能总分、COPD知信行，共可解释72．6％的方差变异。结论AECOPD患者存在较高的SPB水平，并且其与应对方式相关。临床护理人员应重视慢性病患者的SPB问题，帮助其建立正确的应对方式，降低SPB水平以促进患者的身心健康。

Objective To investigate the relationship between self-perceived burden （SPB） and coping style in patients with acute exacerbation of chronic obstructive pulmonary disease and SPB influencing factors. Methods From December 2014 to May 2015, a total of 183 patients with acute exacerbation of chronic obstructive pulmonary disease （AECOPD） were investigated by the Chinese version of self-perceived burden scale i SPBS） and medical coping modes questionnaire（MCMQ） in Department of Respiratory Medicine Daqing People＇s Hospital and Daqing General Oilfield Hospital. Pearson correlation analysis, univariate analysis and multiple linear regression analysis were used. Results The average score of SPBS was （35.13 ± 6.69 ）, which was at a moderate level; the total score of MCMQ was （42.96± 4.28 ）, within which the dimensions of confronting, evading and yielding had statistical difference with national norm （ P 〈 0. 05 ）. The SPBS total score of AECOPD was negatively correlated with coping style of confronting and evading （r = -0.41, -0. 31 ; P 〈 0. 01 ）, but positively correlated with the yielding factor （ r = 0. 49, P 〈 0. 01 ）. Multiple linear regression analysis showed that influencing factors for SPB included education background, families average income, medical insurance mode, total score of self-efficacy, COPD related knowledge, recognition and behavior, which could explain 72.6% of variance. Conclusions AECOPD patients have relevant high SPB level, which has correlation with coping style. Clinical nursers should pay more attention to patients＇ self-perceived burden, and help them establish the correct ways of coping and confronting with disease optimistically, in order to promote the patient＇s physical and mental health.