The Relativity Of COPD Patients' Perception Of Chronic Disease Management,Self-mangement Ability And Quality Of Lives

BACKGROUNDCOPD(chronic obstructive pulmonary disease)is one of chronic common pulmonary disease with a high incidence and mortality rate.This disease is making a serious influence to patients' work ability and life quality,and a huge pressure and economic burden to patients' families and society.So,we should pay more attention and perform more researches to solve problems associated with this disease.Nowadays in China,some achievements have been reached in the prevention and management of some chronic diseases,such as hypertension and diabetes.But as to COPD,many shortages and defieciencies exist in the management of this disease.Thus,more researches and trials should be explored to establish a complete medical management system adapted to Chinese conditions.OBJECTIVETo supply suggestions and evidences for establishing validated health education measures by clarifying the correlations among chronic disease management level,self-management level,and quality of life.METHODSBy using methods of cross-sectional study,a part of COPD patients visiting the repiratory department of a tertiary A hospital in Jinan city from July 2015 to June 2016 were investigated by answering questionnaires.The collected questinnaires include the general data,COPD Self-Management Scale,Chronic Disease Management Scale,and quality of COPD patients'lives.Data were statistically analyzed by using SPSS Statistics and SPSS Amos 21.0 softs.RESULTS1.The mean score is(3.00±0.57)on chronic disease management test,(3.34±0.77)on coherent dimensions/problem resolution.The medians of initiative,service system,goal setting,and follow-up were 3.33?2.67?2.9?2.4 respectively.2.1n the self-management accessment of all evaluated patients,the lowest score was 95,the highest score was 238,and the average score was(160.3±25.56).Patients at the medium level occupied 63.6%of all patients(126 cases);patients at the high level occupied 18.7%of all patients(37 cases);patients at the low level occupied 17.7%of all patients(35 cases).3.The scores of COPD patients' life quality questionnaires arranged from 2 to 20,and the average score was(10.51 ±3.93).According to the scores of life quality,COPD patients were divided to 4 levels:50%of patients in the low or lower levels;35.9%of patients in the medium level;while only 14.1%of patients in the higher level.4.1n the evalution of life quality,there were statistical differences among patients with different characteristics of social demography(P<0.05).The different characteristics of social demography include marrige status,living places,education,and monthly incomes.Otherwise,the scores of quality of lives was positively related with ages(r=0.460).5.In the regression analysis,after the factors of ages,incomes and perception of chronic disease management were included and evaluated in the regression models,the variation of 64.6%could been explained in the scores of life quality.Among these factors,the perception of chronic disease management influenced the variation mostly,and made a negative relativity with the score of life quality(standardized regression coefficient=-0.641).6.The scores of COPD patients' perception of chronic disease management made a dramatically negative relativity with the score of life quality(r=-0.739,P<0.01).7.The scores of COPD patients' self-management made a dramatically negative relativity with the score of life quality(r=-0.608,P<0.01).8.The scores of several dimensions including COPD patients' perception of chronic disease,initiative,goal setting,problem solution,and follow-up were significantlly related with the scores of patients' chronic disease managemnet,whereas the scores of service and practice setting were not related with daily life management of patients.9.Path analysis has shown that self-management of COPD patients is an intermediary factor between the perception of chronic disease management and quality of life;in other word,the quality of COPD patients'lives could been directly influenced by the perception of chronic disease management,while indirectly influenced by self-management.CONCLUSIONS1.Take together,the chronic disease management of COPD patients has been evaluated at a medium level.2.About 63.6%of COPD patients have gotten an medium assessment in the self-management evaluation.3.Taken together,a majority of COPD patients' life quality were unsatisfied,and 50%of patients in the low or lower levels.4.The self-management of COPD patients was an intermediary factor between the perception of chronic disease management and quality of life.