| Objective:To analyze the situation and causes of psychological pain of elderly patients wit-h chronic obstructive pulmonary disease(COPD)in community,and to explore the v alue o-f Distress Thermometer(DT)in psychological intervention treatment.Methods:This study is divided into two parts:1.This study takes the pre-survey results of DT scale(there are 20 meaningful items)as the independent variable.Due to the limited experimental funds and the experimental time at least half a year,the number of samples is designed with five times the data of independent variable items,a total of 100 cases.According to the 2020 WHO definition as people over 60,this study sample was drawn using randomized digital tables from COPD people aged 60 or older treated in some community hospitals of Yijishan Hospital of Wannan Medical College from September 2020 to September 2021.After obtaining the informed consent of the patients,the patients were investigated by general information questionnaire,Distress Thermometer(DT)and World Health Organization Quality of life scare-brief table(WHOQOL-BREF).After collecting the questionnaire and processing the data,SPSS20.0 statistical software was used to evaluate the degree of psychological pain and quality of life of elderly patients with COPD in community.Chisquare test and logistic regression analysis were carried out for the general situation and psychological pain,Spearman correlation analysis was carried out between the quality of life and the degree of psychological pain.2.According to the results general data analysis,100 patients who completed the questionnaire were divided into experimental group and control group by stratified random grouping according to there educationgal level,marriage,course of disease and medical payment method.The demographic characteristics between the experimental group and thecontrol group were compared by chisquare test.According to the results of the first survey,one hands the health education,strengthening doctor-patient communication,social support,psychological intervention,respiratory guidance,exercise and other intervention measures were carried out for the patients in the experimental group on the basis of routine treatment,on the other hands the patients in the control group were only provided routine treatment.Half a year after the intervention,not only the above questionnaire survey was conducted again,but also the data were counted and collected.After data processing,SPSS20.0 statistical software was used to compare the degree of psychological pain before and after intervention in the experimental group,the degree of psychological pain before and after intervention in the control group and the risk factors of psychological pain before and after intervention in the experimental group;Rank sum test was used to compare the scores of DT scale and WHOQOLBREF scale before and after intervention between patients in the experimental group and patients in the control group,patients in the experimental group and patients in the control group after intervention,patients in the experimental group and patients in the control group before and after intervention.Results:1.The incidence of significant psychological pain in elderly patients with COPD in the community was 65%.The average score of DT is 4.85.In general,education level、marriage、course of disease、medical payment method and economic problems、no time and energy to do housework、 transporttation、no time and energy to take care of children、work/school、memory decline/inattention 、loneliness、sleep、depression、loss of interest in daily life、getting along with children/the elderly、getting along with the medical staff 、 breathing 、 dry skin 、 dizziness 、 pain 、 limited physical activity 、 edema 、 fatigue 、 eating 、 bathing were the risk factors of significant psychological pain,which the course of disease 、 economic problems 、 breathing and fatigue were independent risk factors.The scores of various fields and self-score in WHOQOL-BREF were negatively correlated with the scores of psychological pain.2.Generally,there was no significant difference(p>0.05)in marriage,age,educational level,medical payment mode,work and course of disease between the two groups;There was significant difference(p<0.05)in the probability of significant psychological pain before and after intervention in the experimental group;Before the intervention,it’s no significant difference(p>0.05)in the scores of WHOQOL-BREF between the experimental group and the control group,but there was significant difference(p<0.05)in the scores of social relations and self-esteem between the two groups half a year after the intervention;Before the intervention,it’s no significant difference(p>0.05)in the scores of DT between the experimental group and the control group,but there was significant difference(p<0.05)in the scores of physical problems,emotional problems and DT between the two groups half a year after the intervention;The concerns,getting along with medical staff,eating,dizziness,pain and dry skin in the problem of list were statistically significant(p<0.05)in the experimental group before and after intervention.Conclusion:1.Not only the Distress Thermometer is used for psychological pain screening for community elderly COPD patients which can easily provide reference for medical staff to understand their psychological status and influencing factors,but also the WHOQOL-BREF can directly demonstrate the patient’s quality of life.There are suitable for the basic assessment of elderly COPD patients in the community.2.The incidence of significant psychological pain in community elderly COPD patients is too high.There are many factors affecting the degree of psychological pain in patients,which the course of disease course,physical fatigue,breathing difficulties and economic problems can lead to significant psychological pain of patients.3.After targeted intervention and treatment,the patients’ psychological pain degree decreased while the quality of life was improved. |
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