| BackgroundChronic obstructive pulmonary disease (COPD) is a chronic and progressive pulmonary disease, characterized by irreversible airflow limitation. Main symptoms include chronic cough, sputum/productive cough, dyspnea, wheezing and so on. Mental diseases such as anxiety and depression are its main complications.This worldwide epidemic disease, lasting for a long time, is recurrent and worsen over time. As the physical sickness deteriorated, mental diseases will also appear and the quality of life will be lowered. Meanwhile, because of the shortness of breath and peripheral muscle atrophy, the ability of self-help daily living is lowered over time, the amount of disabilities increases and the patient will eventually be forced out of social activities, with the emergence of mental problem that reject social interactions. With less and less support from the society, the level of mental unhealthiness and the quality of life will be further lowered. Now it has become a worldwide public health problem, significantly affecting the mental and physical health and the quality of life of patients, and caused sever economic as well as social burden. The family function and social support can motivate the buffer protection in an emergency of the patients and adjust their thinking and emotion to keep them in good mood and thus achieve the ultimate purpose, to promote the mental and physical health and the quality of life of COPD patients. Since the 1970s, as the new index system with the quality of life as the evaluation of health level is introduced into the field of medical research, family functioning and social support and other concepts have been introduced into the field of medicine. Family functioning and social support plays an increasingly important role in improving the psychological status and the quality of life of patients with COPD. In recent years, more and more attention have been paid to research on the psychological status and quality of life of the COPD patients, which still have some deficiencies listed as follows:(1) Focus more on studies on a single factor and less on the influence and mutual relations between factors.(2) There are few studies on the psychological status and the quality of life of patients with COPD based on the combination of family functioning and social support as well as the mechanism of their mutual influence.(3) There are few studies on how to improve the psychological status and the quality of life of patients with COPD by interfering with family functioning and social support.This study, based on the descriptive study of the family function, social support, psychological status and the quality of life for the DOPD patients, adopted the analysis of multi-factor to investigate the factors leading to the social support, psychological status and the quality of life of COPD patients as well as the relation between family function,social support and the quality of life.It can help function the roles of family and society better, promote the limitation of the bio or physical treatment in the chronic diseases. Besides, it also provides the scientific proofs of the choices as well as the promotion of treatment and nursing of patients with chronic diseases.The innovation of this study lies in the adoption of the analysis of multi-factor. Nowadays, there are only a few reports about studies, which adopt the analysis of multi-factor, on investigating the factors leading to the social support, psychological status and the quality of life of COPD patients. The studies on the relation between family function,social support and the quality of life of the COPD patients are of the same. Therefore, this study has certain sense of innovation.Objective:1. To know more about the present situation of the family function, social support, psychological status and the quality of life of COPD patients.2. To analyze the factors influencing the social support, psychological status and the quality of life for the DOPD patients.3. To investigate the relation between family function,social support and the quality of life.4. To provide the solution to promoting psychological status and the quality of life for the DOPD patients according to the family function and social support, and scientific proofs of the treatment and nursing of patients with chronic diseases.Significance(1) This research discussed the psychological state and the quality of life of the patient with COPD through the family function and social support, which not only helped understanding the the influences of the family function and social support on the psychological state and the quality of life of the patient with COPD, but also expended the ideas of the relation research on the family function, social support, psychological state and the quality of life.(2) The research enriched the domestic research on the psychological state and the quality of life of the patient with COPD. The former domestic research only discussed the psychological state of the patient with COPD through social support and treatment. This research intended to discuss the psychological state and the quality of life of the patient with COPD through the family function as well as the social support. Based on this relation research, the solution to promoting the psychological state and the quality of life of the patient with COPD was inspired. Beside, the results laid the foundations of further discussion on the influence of the psychological state and the quality of life of the patient with COPD on the clinical prognosis.(3) Patients with COPD are in poor psychological and physical state after long-term diseases. Compensation can improve the psychological state and the quality of life of the patients. The discussion on the compensation of the family function and social support can function the roles of family and society better, making up the deficiency of the biological or physical medical methods on the treatments of chronic disease.Research Object:We selected 250 patients, including the out-patients and in-patients, of pneumology department in three large hospitals in Xiashan District, Zhanjiang to fill the questionnaires during November 2014 to May 2015Inclusive Criteria:1. The patients must be diagnosed with COPD under the standard of Global Initiative for Chronic Obstructive Lung Disease(GOLD).2. The patients must be able to communicate effectively and in good conscious state.3. The patients must be willing to participate in this study.Exclusive Criteria:1. Patients with sever diseases of heart, liver, brain, kidney and malignant tumor.2. Patients requiring mechanical ventilation.3. Patients with other sever lung diseases and disabilities which may impact the life quality of patients.Methods:This study adopted questionnaire research method. The questionnaires included APGAR, SSRS, SDS, WHOQOL-BREF. Investigators consist of six undergraduates from the Guangdong Medical College received training before setting out the questionnaire. The investigators record the answers of the illiterate patients or patients with only elementary education by asking. According to sample quantity calculation,250 copies was released and collected, including 237 effective copies. All statistic analysis were done with SPSS 15.0 software, including general analysis, t-test,%test, deviation analysis and Logistic regression analysis.Results1. Scores of physiological aspect, psychological aspect, social relation, environmental condition and comprehensive health self-evaluation were 59.57±15.73,56.99±13.01, 64.28±14.82,58.70±11.53, and 74.97±12.61 respectively. The scores for the physiological aspect, psychological aspect, social relation, environmental condition of the quality of life of male patients with COPD were higher than those for the female; the scores for the social relation of the quality of life was higher in the COPD patients with a higher education level than that for the lower education level; the scores for the physiological aspect, psychological aspect, social relation, environmental condition of the quality of life of was higher in the COPD patients with higher income level than those for the lower income level; the disease severity is higher, the scores for the physiological aspect, psychological aspect, social relation, environmental condition of the quality of life is lower.2. There were 237 patients with chronic obstructive pulmonary disease (34.6%),98 of them have mild depression (41.4%),57 of them have moderate depression (24.1%), and none has severe depression. The total depression was 65.4%. The occurrence of depressive symptoms was related to age and self-rating health status of the COPD patients, OR and 95%CI were 2.540(1.449-4.450) with 1.570(1.147-2.149) respectively.3. The score of objective support for 237 patients with chronic obstructive pulmonary disease was 9.17 ±3.59 and the score of utilization rate of support was 23.24 ±5.45, support availability with 7.41 ±1.84 and the total score of social support was 39.82 ±8.81. Objective support of different ages, different occupation, education level, income level and degree of the disease was statistically significant (P<0.05); Subjective support of different ages, education level and the degree of disease was statistically significant (P<0.05); To support the use of different degrees of disease was statistically significant (P<0.05); Social support scores of different ages, education level, income level and degree of the disease was statistically significant (P<0.05). Logistic regression analysis showed that age, income level and severity of disease were the influential factors of social support in COPD patients.4. The score of family function for 237 patients with chronic obstructive pulmonary disease was 7.07±2.42; Family well-functioning in patients with objective support, subjective support and social support score was higher (P<0.05); Family well-functioning in patients with psychological field survival quality score was higher (P<0.05); Patients whose social support score was higher also had higher score in physiological aspect, social relations and the environmental quality of life. (P<0.05). Logistic regression analysis showed that gender, income level, disease level, the use of support, scores of physiological field and psychological field were the influencing factors of quality of life.Conclusionl.The quality of life in patients with chronic obstructive pulmonary disease was influenced by sex, income, level of education and disease severity. Therefore, more attention should be paid to health education and personalized care to improve the quality of life of COPD patients. For different patients, in addition to standard treatment, nursing should be done according to the person’s conditions. Strengthen psychological care of patients will improve the quality of life of patients.2. Depression in patients with chronic obstructive pulmonary disease occurrence rate is high and is affected by age, education, self-rating health status and other factors. Society and family should pay more attention to the patients, strengthen mental health instruction, and take care of the patient’s mood.3. The social support of patients with chronic obstructive pulmonary disease was influenced by age, occupation, education level, income level and severity of disease. Medical staffs should seek for different social support according to different patients in order to improve the patient’s social support level in better social-supporting environment and promote their recovery.4. Family function and social support have close relation with the quality of life of patients with chronic obstructive pulmonary disease. Therefore good family function and social support benefit the recovery of patients. Medical staffs should pay more attention to all the factors influencing the quality of life of patient with COPD and improves the communication among the patients, families and society, to help patient get more family and social support as much as possible and promote the rehabilitation. |
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