慢性阻塞性肺疾病患者家庭照顾者孤独感影响因素及护理对策分析

Analysis of Influencing Factors and Nursing Countermeasures of Loneliness in Caregivers of Chronic Obstructive Pulmonary Disease

目的:探讨慢性阻塞性肺疾病(COPD)患者家庭照顾者孤独感现状和影响因素,并分析护理对策,为临床护理提供依据。方法:选取2021年1—12月联勤保障部队第九〇九医院收治的192例COPD患者的家庭照顾者作为研究对象,采用一般资料调查表、孤独感中文简版量表(ULS-8)、照顾者负担量表(ZBI)进行问卷调查,比较不同人群孤独感异同情况、照顾者负担和孤独感的关系、孤独感的影响因素。结果:患者自身因素对其主要照顾者孤独感的影响分析发现,不同年龄、婚姻状况、子女人数、月平均收入、医疗费用支付方式、辅助排痰、活动情况、住院次数的患者孤独感评分比较,差异有统计学意义(P<0.05)。照顾者自身因素对孤独感的影响分析发现,不同日平均照顾时间、累计照顾时间、心理负担分级照顾者孤独感评分比较,差异有统计学意义(P<0.05)。经Pearson相关性分析结果显示,照顾者负担状况与孤独感呈正相关,差异有统计学意义(r=0.647,P<0.001)。经多元线性回归分析结果显示,医疗费用支付方式为自费、日平均照顾时间>6 h、照顾者心理负担分级为中重度是照顾者孤独感的独立影响因素,差异有统计学意义(P<0.05)。结论:医护人员应重视COPD患者照顾者在照护过程中的孤独感体验,通过改进护理方式方法给予其心理关怀,进而提高COPD患者照顾者心理韧性和照护水平。

Objective:To investigate the current situation and influencing factors of loneliness among family caregivers of chronic obstructive pulmonary disease(COPD),and to analyze the nursing countermeasures,in order to provide a basis for clinical care.Methods:Family caregivers of 192 COPD patients admitted to the hospital from January to December 2021 were selected for the study.A general information questionnaire,the Chinese short version of the loneliness scale(ULS-8),and the caregiver burden scale(ZBI) were used to conduct the questionnaire survey.The similarities and differences in loneliness,the relationship between caregiver burden and loneliness,and the influencing factors of loneliness were compared among different populations.Results:Analysis of the impact of patients' own factors on their primary caregiver's loneliness revealed statistically significant differences in loneliness scores comparing patients of different ages,marital status,number of children,average monthly income,mode of payment for medical care,assisted sputum evacuation,mobility,and number of hospitalizations(P<0.05).The analysis of the effect of caregiver's own factors on loneliness found that the difference between the loneliness scores of caregivers with different daily average caregiving time,cumulative caregiving time,and psychological burden grading was statistically significant(P<0.05).The results of Pearson correlation analysis showed that caregiver burden status was positively correlated with loneliness,and the difference was statistically significant(r=0.647,P<0.001).The results of the multivariate linear regression analysis showed that the medical fee payment method of self-payment,average daily caregiving time >6 h,and caregiver's psychological burden classification of moderate to severe were the independent influencing factors of caregiver loneliness,and the difference was statistically significant(P<0.05).Conclusion:Healthcare professionals should pay attention to the experience of loneliness of caregivers of COPD patients in the process of caregiving,and give them psychological care by improving nursing methods and approaches,thus promoting the psychological resilience of caregivers of COPD patients and the level of caregiving.