| Purpose1.Describe the current status of frailty in COPD patients.2.Analyze the influencing factors of COPD patients’ frailty from the aspects of physcial,psychology and society.MethodsIn this study,a cross-section survey method was used to investigate 248 patients with COPD who were admitted to a third-class general hospital,a third-class specialist hospital and a second-class hospital in the department of respiratory medicine in outpatient department or in hospital from May 2019 to December 2019.Self-made general data questionnaire,Chinese version of Tilburg frailty scale(TFI),self-efficacy scale,family support scale,hospital anxiety and depression scale and social support scale were used to investigate.Use Epidata3.1 for data entry.Use SPSS22.0 to statistical analysis of data,use the person correlation analysis and multiple linear regression analysis in patients with frailty relevance to other influencing factors,and AMOS22.0fitting structural equation model,etc.Results1.In this study,276 questionnaires were collected and 248 valid questionnaires were collected.Among them,215 were males and 33 were females,and their age distribution ranged from 33 to 95 years old,with an average age of(68.02±7.00)years old.2.In this study,the subjects’ GOLD grades ranged from mild to severe,accounting for 20.56%,31.45%,35.08% and 12.90%,respectively.m MRC grades 0～4 accounted for 20.56%,23.79%,19.76%,26.21% and 9.68%,respectively.79.43% of the patients had a history of smoking,of which 26.61% had not quit smoking.60.32% of the patients were associated with other chronic diseases,and the average charleson complication index was(1.14±1.35)points.The patients had moderate nutritional status and BMI On average(22.15±4.84),the proportions of underweight,normal,overweight and obese were 22.18%,47.98%,22.18% and 7.66%,respectively.3.In this study,the morbidity of frailty in COPD patients was 65.32% with a threshold of 4,The incidence of physical,psychological and social frailty were 47.60%、82.30% and 47.20%,respectively.the total mean score of frailty was(4.98±2.74),the total mean score of physical frailty(2.69±1.92),the total mean score of psychological frailty(1.73±1.25),and the total mean score of social frailty(0.62±0.76).4.In this study,the average self-efficacy score of COPD patients was(7.23±1.62)points,and the average family support score was(12.18 ±2.68)points.The average score of social support was(36.25±6.73).The average score of anxiety was(4.42±3.57),and the average score of depression was(4.96±3.55).The morbidity of anxiety and depression were 18.50% and 21.77% respectively.5.The result of independent sample T test or variance analysis between the total score of frailty and score of physical,psychological,social frailty with social and demographic data and disease related information in the study shows that frailty total score have statistical significance(p < 0.05)in sex,monthly income,smoking,GOLD grade,m MRC classification statistical significance(p < 0.05),physical frailty with statistical significance(p < 0.05)in age,sex,smoking and grade of GOLD,m MRC grading,mental frailty on smoking,GOLD grade,m MRC grading was statistically significant(p < 0.05),the social frailty on age,marital status,and grade of GOLD was statistically significant(p < 0.05).Person correlation analysis showed that the frailty had a strong negative correlation with self-efficacy(correlation coefficient-0.66),a weak negative correlation with family support and social support(correlation coefficient-0.32 and-0.34,respectively),and a weak positive correlation with anxiety and depression(correlation coefficient 0.38 and 0.35,respectively).6.On frailty scores,physcial frailty,mental frailty,social frailty as the dependent variable,with single factor analysis was statistically significant variables as independent variables in the multiple linear regression analysis,the results in the model of frailty total score as the dependent variable,m MRC class 3,4 and self-efficacy has statistical significance(p<0.01),the partial regression coefficient was 1.36,2.81,0.70,respectively.In the model of body frailty as the dependent variable,women m MRC class4 and self-efficacy of control the confidence of the fatigue was statistically significant(p<0.01),and the partial regression coefficients were-1.17,1.73 and-0.23,respectively.In the model of mental frailty as the dependent variable,self-efficacy,anxiety was statistically significant(p <0.01),and partial regression coefficients were-0.67 and 0.68,respectively.The objective support of family support and social support was statistically significant in the model with social frailty as the dependent variable(p<0.01),and both partial regression coefficients were-0.09.7.The structural equation model was constructed based on the classification of m MRC,self-efficacy,anxiety,depression,family support,social support,total score of frailty,physical frailty,psychological frailty,and social frailty.Non-parametric fitting index(NFI)=0.966;Relative fitting index(CFI)=0.994;Approximate error root mean square(RMSEA)=0.029.The results showed that self-efficacy could negatively predict the development and occurrence of frailty(p<0.001),and m MRC grade could positively predict the occurrence of frailty(p<0.001)。Moreover,the correlation between anxiety and self-efficacy and m MRC grading in the structural equation model was statistically significant(p<0.001).Conclusion1.COPD patients have a high degree of frailty,which is dominated by psychological frailty.2.The factors influencing the felling of patients with COPD included age,smoking status,marital status,monthly mean income,gender,anxiety,depression,family support,social support,m MRC rating,and self-efficacy.Among them,family support,social support and self-efficacy can negatively predict the occurrence of fattening,while m MRC grade,GOLD grade and anxiety and depression can positively predict the occurrence of fattening,with the strongest correlation between self-efficacy and m MRC grade.At the same time,anxiety is correlated with self-efficacy and m MRC rating. |
PDF Full Text Request