Research On The Condition And Influencing Factors Of COPD Patients' Self-management During Stable Period

BackgroundChronic obstructive pulmonary disease(COPD)is a respiratory disease characterized by restricted and limited flow of air,long duration,and variety of complications.There is currently no effective intervention in the treatment of COPD,which bring economic burden to patients and families.COPD patients' self-management is based on self management theory of chronic diseases,its significance lies in by helping patients keep changing behavior,make the patients in good health status and health function.Because most of the time living in the home or community,COPD patients need to assume the risk alone to prevent disease recurrence or increase,so the self management is more and more important.ObjectivesWith self-management scale for patients with chronic obstructive pulmonary scale as measuring tool,found out self management status and influencing factors among Guangzhou plateau COPD patients,and put forward to improve and promote self management suggestions and strategies in the patients with COPD stabilization.The research objectWith the COPD patients with stable period in Guangzhou as the research objects,within June 2016 to January 2017,convenience sampling method was carried on in hospitalized patients with COPD in two hospitals of Guangzhou.The method1.literature analysisThrough the system retrieval and review of literature,to understand the self management status of the patients with COPD stabilization,provide theoretical basis and research base for research design.2.questionnaire survey methodAssume convenience sampling method,questionnaires was carried out by 209 patients with COPD in two hospitals of Guangzhou.Questionnaires contents includes:?"general data survey questionnaire";?�self-management formal scale for patients with chronic obstructive pulmonary disease";?"quality of life scale with adult of chronic obstructive pulmonary disease";?"management evaluation questionnaire with chronic disease".2.statistical methodStatistical methods include descriptive statistics,liability and validity analysis,two independent samples t test,single factor analysis of variance(One-Way ANOVA),Multivariate linear regression analysis and correlation analysis.Result1.Questionnaire results:225 questionnaires were distributed,and 221 was taken back.The response rate is 98.2%.And 209 questionnaires were valid,effective rate is 94.6%.1.2.Reliability and validity of self-management scale:(1)reliability analysis:?Internal consistency reliability:the self-management scale Cronbach's alpha coefficient is 0.844.? Split-half reliability.The spot trial results indicated a Spearman-Brown split-half reliability of 0.674.(2)validity analysis:?KMO test:Kaiser-Meyer-Olkin index is 0.733 and the correlation was weak,indicating that the data was suitable for the analysis of factors.? Factor analysis:eight factors were extracted according to the scale design dimension,and the cumulative contribution rate was 66.899%.3.The findings of self-management in patients with COPD(1)Self management level:The self-management total score is 141.68 + 141.68 points in 209 cases of patients with COPD during stable period in Guangzhou.(2)Auxiliary scale scores:?Scale of quality of life:total score is 79.35�10.08 points.?Chronic disease management:total score is 56.46�6.41 points.4.The single factor analysis?Multivariate linear regression analysis and correlation analysis on influential factors of self management with COPD patients during stable period:(1)the single factor analysis:using independent sample t test and analysis of variance to find the differences in different factors of self-management score:gender,age,the different main caregivers,different marital status,oxygen therapy,smoking,the different medical insurance payment,different monthly income per capita and different duration,the number of complications,different cultural degree,different mMRC score,and limited ability to different activities,the comparison between self-management scale score,differences were statistically significant.(2)Multi-factor analysis:The analysis of the relationship between the scores of self-management and the basic data of the study subjects was carried out using the multivariate linear regression analysis.Analysis results show that the age,the condition of oxygen,daily life ability,social activity ability,goal setting and problem solving are main influencing factors affecting the self-management level of patients during stable period in Guangzhou hospitals(P<0.05).(3)correlation analysis:The degree of linear relationship between two variables was studied by the correlation analysis.The results showed that the total score of survival quality was moderate to the overall score of self-management(r=-0.408,P=0.000).The overall score of the management of chronic diseases was moderately positive in terms of the overall score of self-management(r=0.434,P=0.000).Strategy discussion1.Increase supporting for patients with COPD during the construction of the health care system;2.Community health agencies should focus on the "action plan" to capture early intervention;3.Strengthen communication between doctors and patients and improve the effectiveness of self-management of patients.