The Development And Trial Of Survey On Knowledge,Attitudes And Practices For Patients With Chronic Obstructive Pulmonary Disease

Objective:1.Design a questionnaire of Knowledge,Attitude/belief,Practice(KAP) for patients with chronic obstructive pulmonary disease(COPD)in China.2.To investigate the status of the knowledge,attitude/belief,practice of pulmonary rehabilitation training for patients with COPD in Gansu Province,and to analyze the influencing factors.Methods:1.Guided by KAP theory,firstly,the literature analysis method,interview method and Delphi method are used to preliminarily formulate the questionnaire of the questionnaire of pulmonary rehabilitation training for patients with COPD.Secondly,the questionnaire is expressed by pre-survey.The logical structure is debugged to form the questionnaire to be tested.Finally,the cross-sectional survey is used to conduct the project analysis and performance evaluation,and finally form a formal questionnaire.2.The convenience sampling method was used to select patients with COPD in four three-level tertiary hospitals in Gansu Province.A survey was conducted on the survey tool using the self-designed general data questionnaire for patients with COPD and the questionnaire on pulmonary rehabilitation training for patients with COPD.The data were analyzed by statistical software SPSS 22.0.All the tests were two-tailed test.The difference was statistically significant at P<0.05.The frequency and composition ratio were used to describe the count data,and the mean±standard deviation was used to describe the measurement data.Two independent samples t test,one-way ANOVA and multiple linear regression were used to analyze the influencing factors of the status of the knowledge,attitude/belief,practice of pulmonary rehabilitation trainingResult:1.(1)In this study,15 experts were invited to conduct 2 rounds of Delphi method.The recovery rates of 2 rounds of correspondence tables were 93.75%and100%respectively.The expert opinion degree coefficient was 0.86 and 0.91respectively.After the completion of the 2nd round Delphi method,the pulmonary rehabilitation training for patients with COPD is preliminarily formed.Knowledge and Knowledge Questionnaire,a total of 43 items.(2)The pre-investigation revised the representation of the knowledge dimension of the questionnaire for the form of pulmonary rehabilitation training,and adjusted the order of the questionnaire items,and discharged according to the content of the knowledge line.(3)The fomal questionnaire includes 26 items.Exploratory factor analysis extracted 4 common factors,and the cumulative interpretation mutation rate reached 65.292%.The distribution of the four factor entries was consistent with the expected.The confirmatory factor results showed that the chi-square(c~2)index/degree of freedom(df)value was 1.543,the approximate error root mean square index(RMSEA)was0.052,and the normalized residual root mean square(SRMR)value was 0.057.The fitting index(IFI)value was 0.932,the comparative fitting index(CFI)value was 0.931,and the non-standard fit degree index(TLI)value was 0.923.The factor load of knowledge 1,knowledge 2,attitude,and behavior were all Above 0.5,the composition reliability(CR)values are all above 0.7,and the Average of variance extracted(AVE)values are all around 0.5.The content validity index of the total questionnaire was 0.890;the Cronbach's?coefficient was 0.852;the half-fold reliability coefficient was 0.864;the test-retest reliability coefficient was 0.957.2.(1)The formal survey included 435 patients with COPD.The scores of the questionnaires were as follows:knowledge dimension was 31.11±7.41,the pass rate was 48.28%;attitude dimension was 14.68±3.83 points,the pass rate was65.06%;the behavioral dimension was 24.01±6.85 points,and the pass rate was24.14%.(2)Multiple linear regression results showed that the factors affecting the knowledge dimension of pulmonary rehabilitation training in patients with COPD were the patient's education level,occupation and whether they had received guidance for pulmonary rehabilitation training.The factors affecting the attitude dimension were the patient's education level,occupation,The course of the disease,comorbidity,depression,and whether or not the lung rehabilitation training guidance;the factors affecting the behavioral dimension score are the patient's education level,occupation,duration,comorbidities,depression status and guidance on whether or not to receive pulmonary rehabilitation training.Conclusion:1.The questionnaire on pulmonary rehabilitation training for patients with COPD prepared by this study has good reliability and validity,and can be used as a survey tool to understand the status of pulmonary rehabilitation training in patients with COPD.2.The level of theoretical knowledge,attitude and compliance of pulmonary rehabilitation training in patients with COPD in Gansu Province is low.The degree of education,occupation,duration of illness,comorbidities,depression,and guidance on whether or not to receive pulmonary rehabilitation training are factors that affect the level of patient knowledge.Therefore,the health education of the patients in the lung rehabilitation training needs to be carried out from person to person to effectively improve the level of knowledge and belief of lung rehabilitation training in patients with COPD.