慢性阻塞性肺疾病患者自我管理水平与DOSE指数的相关性

The correlation of self-management and DOSE index among patients with chronic obstructive pulmonary disease

目的调查慢性阻塞性肺疾病患者(COPD)自我管理水平的现状,探讨自我管理水平与DOSE指数的相关性,以指导肺康复治疗。方法采用自行设计的一般资料调查表、COPD临床问卷、COPD患者自我管理量表和DOSE指数评分系统对159例患者进行问卷调查。结果患者自我管理总分为(162.31±24.25)分,自我管理水平低,分层回归分析显示,自我管理总分是DOSE指数的一个重要影响因素(β=-0.335,ΔR^2=0.076,P<0.001),偏相关分析显示自我管理5个维度得分与DOSE指数均呈负相关(r=-0.225^-0.283,P<0.05),其中自我效能与DOSE指数的相关性最强。结论在肺康复治疗中,要加强患者自我管理的干预,重点在于帮助患者获取疾病相关信息,增强控制疾病的信心,降低其DOSE指数,进而降低患者的疾病恶化风险,减少住院率和病死率。

Objective To investigate the status of self-management in patients with chronic obstructive pulmonary disease(COPD), and to investigate the correlation between self-management and DOSE index. Methods Totally 159 patients with COPD were investigated by general information questionnaire, chronic COPD questionnaire, Self-Management Scale(SMS) and the DOSE index at the respiratory departments of four hospitals in Tianjin. Results The total score of self-management in all participants was in a low level(162.31±24.25). Hierarchical regression analysis showed that self-management behavior was the main factor affecting the DOSE index(β=-0.335,ΔR^2=0.076, P<0.001);and partial correlation showed that the scores of five domains had negative correlation with DOSE scores(r=-0.225--0.283, P<0.05), and the correlation between self-efficacy and DOSE score was the most significant. Conclusion In pulmonary rehabilitation, self-management intervention is essential to help COPD patients to acquire more information about the disease and get more confidence in controlling it, reduce the DOSE score, the risk of exacerbations, the admission rate and mortality.