Present Situation Investigation And Intervention Study On The Hope Level Of Patients With Chronic Obstructive Pulmonary Disease

Objective To describe hope level on patients with chronic obstructive pulmonary disease(COPD).To determine the relationship between patients' hope with quality of life(QOL)and family caregivers' hope,and the influencing factors of patients' hope.To understand the experience of hope in COPD patients by Semi-structured depth interview.To explore a comprehensive nursing intervention mode that can effectively improve COPD patients' hope level and self-efficacy in China.Methods This study consisted of three parts including investigative study,qualitative study and intervention.(1)The investigative study:118 pairs of COPD patients and their family caregivers from the first affiliated hospital of guangxi medical university were recruited as a convenience sample from the June of the year of 2015 to the April of the year of 2016.The general information questionnaire,Herth hope Index Scale(HHI)and COPDAssessment Test(CAT)were used to assess demographics,hope level and quality of life of patients and their caregivers.Analyzing the relationship between hope level of patients with quality of life and caregivers' hope level;The influencing factors of the hope level of COPD patients were analyzed by multiple stepwise regression analysis.(2)Thequalitative study: To explore the experience of hope in patients with chronic obstructive pulmonary disease,sixteen representative patients from the first part were recruited into the semi-structure interviews.(3)The intervention study:From the May of the year of 2016 to the January of the year of 2017,sixty patients with COPD were respectively recruited from Pneumology Department(ward one 30,ward two 30)of the first affiliated hospital of guangxi medical university.The patients from ward two as control group were given routine care,The patients from ward one as intervention group,on the basis of giving conventional nursing increase comprehensive nursing intervention.Before the intervention and six weeks after intervention,the patients' hope level and self-efficacy were assessed by HHI and COPD self efficacy scale(CSES),to evaluate the effectiveness of comprehensive nursing intervention model in improve hope level and self-efficacy of patients with COPD in China.Results(1)The total HHI score of 118 COPD patients was 33.69�4.66,The hope level was at middle level for 64.4% and at high level for 35.6% of patients.The total CAT score of patients and HHI score of caregivers was 22.68� 5.60,35.03 � 4.41 respectively;According to the results of Pearson correlation analysis,COPD patients' hope score was significantly negative relationship with CAT score,and significantly positive relationship with total score and each dimension score of hope of caregivers;The multiple stepwise regression analysis found that quality of life,educational level,whether on-the-job,marital status,medical payments and hope level of caregivers could explain 55.6% of the variation of patients' hope level.(2)Interview data were analyzed using Colaizzi's seven-step analysis method and Nvivo8.0 software by the researchers,Four themes were extracted:(1)understandings of hope:hope is the desire to future life,live a good present,effort to treatment;(2)barriers ofhope:Physical discomfort,cognition deficiency for disease,negative emotion,family not harmonious,poor treatment,afraid of disease recurrence;(3)promote factors of hope: an improvement of diease,external support,intrinsic goals.(4)hope let patients pay actions�to change current situation:change bad habits and active learning.(3)Before the comprehensive nursing intervention,there was no significant difference between the two groups in hope level and self efficacy(P >0.05).After the intervention,there was statistically significant difference between the two groups in hope level and self efficacy(P<0.05);The hope level and self efficacy were different before and after the intervention in the intervention group(P <0.05).Conclusion(1)The hope of COPD patients were medium to high level,But their quality of life was seriousness.And the hope of family caregivers were Also medium to high level.(2)There were many factors affected the hope level of COPD patients,The main influencing factors include the quality of life,educational level,whether on-the-job,marital status,medical payments and hope level of caregivers.(3)Through depth interviews,it had revealed the COPD patients' understanding of hope,the factors that promote the hope and the factors that hinder the hope,hope let patients pay actions �to change current situation.The results of this study explain the current situation of COPD patients with medium to high hopes.It will help medical works to fully understand the needs of patients,and provide a theoretical basis for further intervention measures for key factors.Improving COPD patients' hope level is great significance to maintain their physical and mentalhealth.(4)The comprehensive nursing intervention model can effectivelyimprove the hope level and self-efficacy of COPD patients in China.