A Mixed Methods Research On The Quality Of Life In Caregivers Of Patients With COPD

Objective:This mixed methods research aimed to comprehensively assess the quality of life in caregivers of patients with chronic obstructive pulmonary disease(COPD)and to identify the associated factors affecting the quality of life of caregivers of COPD patients.Methods:1.In the first part of this research,simultaneous triangulation design was adopted.Qualitative study and quantitative study were conducted at the same time.The findings of qualitative study and quantitative study were compared and integrated carefully to obtain a comprehensive understanding of the quality of life of caregivers of patients with COPD.Qualitative descriptive design was used in qualitative study.Purposive sampling method was adopted,and 12 caregivers of COPD patients from 4 hospitals in Jinan,Shandong from December 2018 to June 2019 were recruited as the study participants.Semi-structured interviews were performed to collect relevant data.Conventional content analysis was adopted to analyze the qualitative data.In quantitative study,cross-sectional design was adopted.Convenient sampling method was used,and 201 caregivers of COPD patients from 4 hospitals in Jinan,Shandong from December 2018 to June 2019 were recruited as the study participants.Data collection was conducted by means of questionnaire.Caregivers' basic information and quality of life were assessed through the basic information questionnaire of caregivers and the mos 12-item short form health survey,version 2.Data entry was performed using EpiData software,version 3.1.Descriptive statistical analysis was performed using SPSS software,version 24.0.2.In the second part of this research,cross-sectional design was used.Convenient sampling method was adopted,and 201 COPD patients as well as their caregivers from 4 hospitals in Jinan,Shandong from December 2018 to June 2019 were recruited as the study participants.Data collection continued on the basis of the first part of this research.COPD patients' basic information,daily living ability,and symptom severity were assessed through the basic information questionnaire of COPD patients,Barthel index,and COPD assessment test.Caregivers' negative emotion,care burden,social support,and coping style were assessed through negative affect subscale of positive and negative affect scale.Zarit caregiver burden interview,perceived social support scale,and trait coping style questionnaire.Data entry was performed using EpiData software,version 3.1.Statistical analyses(descriptive statistical analysis,two independent samples t-test.analysis of variance,Pearson correlation analysis,Spearman correlation analysis,multiple linear regression)were performed using SPSS software,version 24.0.Results:1.In the first part of this research,seven themes and several sub-themes were obtained in qualitative study:(1)poor physical condition(? suffer from multiple chronic diseases,?extreme fatigue),(2)great psychological pressure(? worry about patient's condition,?fret over realistic problems),(3)no time or space of my own,(4)family relationship(?endure patient's emotional release,?relationship with other family members),(5)economic pressure.(6)impact on work,(7)acceptance and compromise of the current living status.According to the results of quantitative study,among the 8 domains of quality of life,caregivers of COPD patients scored the lowest in general health,mental health,and bodily pain.The mean scores of caregivers'physical component summary(PCS)and mental component summary(MCS)of quality of life were(48.24±10.79)and(48.88±10.12),respectively.2.In the second part of this research,according to the results of multiple linear regression,the associated factors of caregivers' physical quality of life(dependent variable:PCS score)were:caregivers' chronic diseases(1 or 2 kinds of chronic diseases:?=-0.427,P<0.001;>3 kinds of chronic diseases:?=-0.567,P<0.001),caregiver-patient relationship(spouse:?=-0.215,P=0.037),caregivers' stressful events in the past 3 months(caregiver has experienced stressful events in the past 3 months:?=-0.148,P=0.009),and the frequency of patients'COPD-related emergency department visits in the past year(?=-0.111,P=0.044).The regression model could explain 48.3%of the total variance.The associated factors of caregivers'mental quality of life(dependent variable:MCS score)were:caregivers'negative coping style(?=-0.276,P=0·001),care burden(?=-0.208,P=0.008),negative emotion(?=-0.167,P=0.025),and family support(?=0.163,P=0.036).The regression model could explain 40.5%of the total variance.Conclusion:1.The quality of life in caregivers of COPD patients is poor,but caregivers also show a certain degree of acceptance and compromise on the current quality of life.Howe ver,despite this,the impact of caring for COPD patients on the quality of life of caregivers still cannot be ignored.There is an urgent need to improve the quality of life of caregivers of COPD patients.2.The associated factors of caregivers' physical quality of life were:caregivers' chronic diseases,caregiver-patient relationship,caregivers' stressful events in the past 3 months,and the frequency of patients' COPD-related emergency department visits in the past year.The associated factors of caregivers' mental quality of life were:caregivers' negative coping style,care burden,negative emotion,and family support.