| OBJECTIVE:1. To investigate the knowledge-attitude-practice (KAP) and quality of life (QOL) in patients with chronic obstructive pulmonary disease (COPD). And analyze the factors associated with QOL in order to explore feasible nursing strategies.2. To test the hypothesis that the systematic and individualized health education (HE) have advantage over random health education in improving the KAP and QOL in COPD patients.METHODS:206 COPD patients were enrolled and their KAP and QOL were investigated by questionnaire, including demographic information, disease-related knowledge-attitude-practice, and QOL scale. 120 patients among those subjects were then randomly divided into two groups, 54 subjects as intervention group have gotten systematic and individualized health education while 45 subjects as control group have gotten random health education. These two kinds of HE methods'outcomes were investigated by KAP questionnaire and QOL scale 6 months later.RESULTS1. Among these subjects, the average correct rate of knowledge about risk factors and rehabilitation were 79.05% and 78.76% respectively, while long-term domiciliary oxygen therapy (LTDOT) and medication treatment were 25.89% and 41.70% respectively. There were 69.66% COPD patients who had correct belief and attitude regarding their disease. And only respectively 18% and 51% subjects who can regularly insist breath training and physical exercise. In respect of the need of disease-related knowledge, 94.2% of subjects said yes. The investigation also showed their need mainly concentrated on prevention (52.4%), treatment (64.1%) and rehabilitation (71.4%). No statistical significance were observed in KAP scores among different education level of those patients (P>0.05).2. The total score of QOL in these patients was (64.70±14.78), and its 4 dimensionalities, namely activity of daily living, society activity, depressed mentality, anxious mentality were (69.23±25.64), (61.90±23.81), (66.67±33.33) and (66.67±33.33) respectively. There was statistically significant correlation between the quality of life and frequency of hospitalization in the past 2 years, marriage, education, course of disease by stepwise multiple regression analysis (P<0.01).3. Six months later, the QOL total score and most of its dimensionalities in intervention group were better than before(P<0.05), and they were superior to control group(P<0.05). The scores of knowledge, attitude and practice in intervention group were all better than before(P<0.05), and by contrast with control group, the scores of knowledge and practice were increased significantly(P<0.05). The scores of KAP in control group were not statistically significant difference before and after health education. We also founded, the number of subjects accepting LTDOT was more than before in intervention group(P<0.05), and by contrast with control group, the time of using it was increased significantly(P<0.01). Meanwhile, both the number of subjects accepting LTDOT and the time of using it were not statistically significant difference in control group before and after health education.CONCLUSION:1. According to these data, the health-related KAP level is not enough in COPD patients, and most of them desire for knowledge. The quality of life in COPD patients is poor,especially in those who are spouseless, with longer disease history, lower education degree, frequently hospitalized and insufficient of healthy behavior. Health education should focus on prevention,treatment and rehabilitation, especially on improving health behavior, such as smoking cessation, exercise training, correct medication using, LTDOT and so on.2. The systematic and individualized health education can help COPD patients increasing knowledge, improving mental health and forming health behavior. Ultimately, it enhances patients' capability of control over their ordinary life and medicine conditions thus improve QOL of them.
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