深圳市尘肺病患者肺康复知信行现状调查及影响因素分析

Investigation on KAP status and influencing factors of pulmonary rehabilitation among pneumoconiosis patients in Shenzhen

目的了解尘肺病患者肺康复知信行现状,分析其影响因素,为进一步制定干预措施提供参考。方法选择2021年1月—2022年12月某医院168名尘肺病住院患者作为调查对象,运用“问卷星”小程序,采用一般资料调查表与自行设计的肺康复知信行现状调查问卷进行调查,通过多元线性回归分析尘肺病患者肺康复知信行影响因素。结果本研究调查对象的知信行问卷总得分为(88.77±14.63)分,得分率为68.28%。知信行各维度得分分别为(41.62±5.93)分、(16.89±1.80)分、(30.26±9.50)分,对应得分率分别为69.37%、84.45%、60.52%,均处于中等水平。知识与态度、知识与行为、行为与态度均呈中等程度正相关(r=0.439、0.507、0.549,均P<0.05)。多元线性回归分析显示,年龄、家庭人均月收入、患共病或并发症是尘肺病患者肺康复知识得分可能的影响因素。其中,与50~59岁组比较,<50岁年龄组患者知识得分提高2.619分(P<0.01);与家庭人均月收入<2000元组比较,2000~4000元组与4000元以上组患者肺康复知识得分分别提高1.991分和3.831分(均P<0.05);相对于存在共病或并发症组,无共病或并发症组肺康复知识得分提高1.976分(P<0.05)。年龄、诊断分期与尘肺病住院次数是尘肺病患者肺康复信念可能的影响因素。其中,与50~59岁年龄组比较,≥60岁组患者肺康复信念得分降低1.963分(P<0.01);与贰期尘肺病患者相比,壹期患者肺康复信念得分提高0.950分(P<0.01);与尘肺病住院2~3次组患者比较,首次因尘肺病住院患者康复信念得分提高1.609分(P<0.01)。诊断分期、文化程度、患共病或并发症是尘肺病患者肺康复行为得分可能的影响因素,其中相比贰期尘肺病患者,壹期患者肺康复行为得分提高6.570分(P<0.01);与初中学历组相比,小学与高中及以上组患者康复行为得分分别提高5.911和5.996分(均P<0.01);与存在共病或并发症组相比,无共病或并发症组肺康复行为得分降低6.100分(P<0.05)。结论尘肺病患者肺康复知识、信念、行为水平均亟待提高。临床上应结合尘肺病患者肺康复知信行现状及影响因素制定相应的护理干预措施,以提高患者知信行水平,改善患者生活质量。

Objective To understand the current status of knowledge,attitude/belief,and practice(KAP)regarding pulmonary rehabilitation among patients with pneumoconiosis,analyze the influencing factors,and provide a reference for further intervention measures.Methods From January 2021 to December 2022,168 inpatients with pneumoconiosis in a certain hospital were studied.The Questionnaire Star applet was used to conduct a survey using a general information questionnaire and a self-designed pulmonary rehabilitation KAP questionnaire.Multiple linear regression analysis was performed to analyze the influencing factors of KAP in pulmonary rehabilitation.Results The total KAP score of the study subjects was(88.77±14.63),with a score rate of 68.28%.The scores for each dimension of KAP were(41.62±5.93),(16.89±1.80),and(30.26±9.50),respectively,with a score rate of 69.37%,84.45%,and 60.52%,respectively,which all were at a moderate level.Knowledge with attitude,knowledge with behavior,and behavior with attitude were moderately positively correlated(r=0.439,r=0.507,r=0.549,all P<0.05).Multiple linear regression analysis showed that age,per capita monthly family income,and comorbidities or complications were possible influencing factors for the knowledge score of pulmonary rehabilitation.Among them,compared with the 50 to 59 year age group,the knowledge score of patients under the 50 year age group increased by 2.619 points(P<0.01);compared with the group with a per capita monthly family income of less than 2000 yuan,the knowledge scores of the groups with an income of 2000 to 4000 yuan and above 4000 yuan increased by 1.991 points and 3.831 points,respectively(both P<0.05);compared with the group with comorbidities or complications,the knowledge score of the group without comorbidities or complications increased by 1.976 points(P<0.05).The age,diagnostic stage of pneumoconiosis,and the number of hospitalizations for pneumoconiosis were possible influencing factors for the belief score of pulmonary rehabilitation.In particular,compared with the 50 to 59 year age group,the belief score of patients aged 60 and above decreased by 1.963 points(P<0.01);compared with patients with stageⅡpneumoconiosis,the belief score of patients with stage I pneumoconiosis increased by 0.950 points(P<0.01);compared with patients hospitalized 2 to 3 times for pneumoconiosis,the belief score of patients hospitalized for the first time increased by 1.609 points(P<0.01).Diagnostic stage,educational level,and comorbidities or complications were possible influencing factors for the behavior score of pulmonary rehabilitation.Compared with patients with stageⅡpneumoconiosis,the behavior score of patients with stage I pneumoconiosis increased by 6.570 points(P<0.01);compared with the junior high school education group,the behavior scores of the primary school and high school or above groups increased by 5.911 and 5.996 points,respectively(both P<0.01);compared with the group with comorbidities or complications,the behavior score of the group without comorbidities or complications decreased by 6.100 points(P<0.05).Conclusions The levels of knowledge,belief,and behavior regarding pulmonary rehabilitation among patients with pneumoconiosis need to be improved.Clinically,corresponding nursing interventions should be formulated based on the current status and influencing factors of KAP in pulmonary rehabilitation among patients with pneumoconiosis to improve their KAP levels and quality of life.