Development Of Specific Anxiety Scale For Patients With Chronic Obstructive Pulmonary Disease And Preliminaryapplication

Objective1.Explore the content and structure of chronic obstructive pulmonary disease（COPD）patient-specific anxiety,and develop COPD patient-specific anxiety scale.2.Test the reliability and validity of the COPD patient-specific anxiety scale to provide a scientific and effective evaluation tool for the evaluation of patient-specific anxiety.3.To investigate the status quo of specific anxiety in patients with COPD by using the COPD patient specific anxiety scale,explore the influencing factors of specific anxiety in patients with COPD,and provide a reference for patients to establish a good psychological coping style and reduce negative emotions.Methods1.To determine preliminary pool of scale entries:Set up the team,based on the literature review panel discussions,using qualitative research method to select 3 A grade hospital of respiratory and critical care medicine COPD patients hospitalized with in-depth interviews,Colaizzi phenomenological data analysis was used for data analysis,Preliminary dimension of determining specific anxiety scale for patients with COPD and item pool.2.Pretesting scale formation:A total of 20 clinical experts,nursing experts,nursing managers and psychological experts from respiratory and critical care medicine department of Grade III and GRADE A hospitals were selected to carry out two rounds of expert letter consultation using Delphi expert letter consultation method.According to expert opinions,the scale was modified and 20 COPD patients were selected for a small sample pre-survey to collect their opinions on the item expression.3.Test reliability and validity of scale:By convenience sampling method,Patients with copd were selected from the department of respiratory and critical care medicine in 3grade A hospitals,Scale clinical testing,using the critical ratio method,correlation coefficient method and Cronbach a coefficient method for screening scale items,to scale the entries for the reliability and validity test,formation of copd patients with specific anxiety scale final version.4.Application of the scale The general data questionnaire,COPD patient specific anxiety scale,COPD patient self-assessment test,general self-efficacy scale and social support rating scale were used to investigate COPD inpatients in two grade A hospitals to understand the status of specific anxiety,and explore the influencing factors of specific anxiety.Results1.After literature reading,discussion,qualitative interview,two rounds of Delphi method expert letter consultation and small sample pre-survey,a pre-test scale containing 6 dimensions and 35 items was formed,in which the anxiety dimension of long-term oxygen therapy as an additional dimension was only applicable to COPD patients receiving long-term oxygen therapy.2.The item analysis of the pre-test scale showed that the correlation coefficient between items 15,20,29,31 and the corresponding total score was less than 0.4,which was removed from the scale.The total Cronbach’a coefficient of the scale is 0.953,and the Cronbach’a coefficient of each dimension is 0.784-0.922.This indicates that the internal consistency of the scale is good.The half-and-half reliability of the scale was 0.812 and the test-retest reliability was 0.906.The content validity index of the scale items was 0.83-1.00,the average content validity index of the scale was 0.90,indicating high content validity of the scale.In the exploratory factor analysis,anxiety about long-term oxygen therapy only applied to patients receiving long-term oxygen therapy,so it was excluded as an additional scale and factor analysis was performed separately.The KMO value of the anxiety scale for disease symptoms and other five dimensions is 0.900,the cumulative variance contribution rate is 67.357%,and the KMO value for the anxiety dimension of long-term oxygen therapy is 0.788,and the cumulative variance contribution rate is 60.780%.In terms of calibration correlation validity,the scores of all dimensions of COPD patitor-specific anxiety Scale were highly correlated with the total scores of SAS scale（r=0.403～0.765,P<0.01）.Finally,a formal scale with 6 dimensions and 31 items was formed,among which the anxiety dimension of long-term oxygen therapy was the additional dimension.3.The total score of 203 COPD patients’ specific anxiety was 93.96 ± 14.06,and the score rate was 64.80%.Among them,the score of anxiety dimension for disease symptoms（22.94±3.84）and the score of anxiety dimension for disease progression（30.25±5.66）was the highest.The scoring rates were 76.47 percent and 75.62 percent,respectively.The score of anxiety dimension of 109 patients with long-term oxygen therapy was（12.21±2.69）,and the score rate was 68.99%.Univariate analysis showed that gender,Cultural level,household income,times of acute exacerbations in the past year,understanding of disease,exercise time,medication status and smoking had influence on patient-specific anxiety scores（P < 0.05）.Multiple stepstep regression showed that gender,Cultural level,quality of life and social support were the influencing factors of COPD patients-specific anxiety.Conclusion1.The patient-specific COPD anxiety scale was developed in this study,which contains 6 dimensions and 31 items.The anxiety dimension of long-term oxygen therapy is an additional dimension,which is only applicable to patients with long-term oxygen therapy.2.The COPD patient-specific anxiety Scale has good reliability and validity,which can be considered as a tool to evaluate COPD patient-specific anxiety.3.The investigation results of COPD patients with specific anxiety show that patients have specific anxiety,and the anxiety dimension score of disease symptoms and disease progression is the highest.Patients with COPD patients with specific anxiety level by gender,educational level,the influence of quality of life and social support,the clinical nursing staff should pay attention to assessment of specificity in patients with anxiety,according to the specificity of anxiety in patients with status quo and the main influence factors make effective intervention measures,reduce patient specific anxiety level,improve the patients quality of life.