Study On Prevalence Of Anxiety And Depression Among Hospitalized Patients With COPD

Background:Chronic obstructive pulmonary disease (COPD) is a group of lung diseases characterized by airflow limitation that is not fully reversible, which is related with the abnormal inflammatory reaction to harmful gases such as cigarette and haze or harmful aerosols, the process is progressive, but also preventable and treatable. In recent years, the prevalence of COPD in adult people over the age of40was about8.2%according to a survey covered many area, and pulmonary function in patients with COPD show progressive loss which seriously affects the labor force and the quality of life. In addition, the morbidity and mortality keep in a high level, leave a heavy financial burden to the patient’s family and society. Now COPD is the fourth cause of death and increasing year by year and till2020, according to the reports of World Bank and World Health Organization, it will become the fifth cause of the world economic burden, COPD has become an important global public health problem and has attracted widespread attention over the world.The quality of life of COPD patients keeps decreasing, and their physical and social activities would be limited while the medical cost was increased. All these changes are due to the prolonged course, repeated episodes and gradually worsened clinical symptoms. At the same time the patients are also susceptible to stress, anxiety, panic, interpersonal communication disorders, as well as guilt, frustration, frustrated despair, suicide and other negative emotions and erratic behavior. Depression is the most common negative psychological manifestations after long-term mental damage. The heavy psychological burden is aggravating factors to anxiety and depressive disorders. In addition, COPD patients are mostly old people, the function of their organs were getting declined, include the cholinergic and adrenergic systems, and there is lack of monoamine neurotransmitters in the brain tissue, which can cause cognitive dysfunction correlates with depressive disorder. Domestic and foreign researchers found that this disease not only affects the patient’s physical function, but also easy to cause psychological disorders and social role changes, affect the patient’s daily life, social, spiritual activities, and even lead to anxiety and depression.This project intends to study the anxiety depression status of COPD patient and the related factors, to provide a scientific basis for improving living quality, the prognosis, mental health education and mental health interventions for hospitalized patients with COPD.Objective:To investigate the incidence of anxiety and depression and its related factors among hospitalized patients with COPD. To provide strategy and suggestions about treating and nursing COPD inpatients according the results and to reduce their anxious and depressive levels and promote the quality of life of COPD inpatients.Methods:A cluster sampling was applied to extract COPD inpatients, Department of Respiratory in Binzhou Medical College Hospital since November2011to September2012100valid samples were selected as experimental group,108Diabetes patients were extracted as control group from Department of Endocrinology Binzhou Medical College Hospital, over the same period. Pulmonary function tests and questionnaires combined as survey methods. The survey includes the following aspects:1general condition of patients and disease situation;2lung function parameters;3Anxiety Rating Scale (SAS);4Self-Rating Depression Scale (SDS);5Family APGAR INDEX. All data were analyzed by SPSS13.0statistical software.Main results:1. No significant difference was found in the general data between the experimental group and the control group, the two groups were comparable, the incidence of psychological disorders such as anxiety and depression was higher in COPD hospitalized patients than which in the diabetes hospitalized patients, the difference was statistically significant.2. One-way ANOVA results showed that anxiety, depression group in COPD hospitalized patients correlate with COPD classification, the COPD disease stage, gender, level of education, medical payment, APGAR, a statistically significant difference was found.3. multivariate regression analysis showed that:the main influencing factors for anxiety in COPD hospitalized patients:COPD classification, COPD stage, gender, medical payment, APGAR. The main influencing factors for depression in COPD hospitalized patients:COPD classification, level of education, gender, medical payment method and APGAR.4.The severity of anxiety, depression in COPD hospitalized patients were significantly correlated with COPD classification, COPD disease stage, gender, level of education, medical payment method and APGAR while there was no significantly correlation with patient age.Conclusions and Recommendations:1. There is a higher incidence of anxiety and depression disorders in hospitalized patients with COPD than which in hospitalized diabetes patients, and anxiety symptoms and depressive symptoms are often concomitant.2.The severity of anxiety and depressive symptoms in COPD hospitalized patients correlates with COPD classification, COPD staging, gender, medical payment method, APGAR and education background significantly.3.There are many influencing factors to anxiety and depression of COPD hospitalized patients, include not only the patient’s own factors and the disease itself, but also social, family support factors, among them the condition of the patient, the family APGAR and medical payment are main influencing factors.4.Medical staff should pay attention to psychological disorders in hospitalized patients with COPD and intervention according to related factors should be taken so as to maintaining COPD inpatient’s mental health and improving their quality of life.