Study On The Correlation Among Discharge Readiness With Mental Resilience And Family Functionin Patients In Chronic Obstructive Pulmonary Disease

Objective:（1）To investigate the discharge readiness,mental resilience and family function of COPD patients;（2）To analyze the influencing factors of discharge readiness in COPD patients;（3）To explore the relationship among discharge readiness,mental resilience and family function in COPD patients;（4）To explore whether the family function of copd patients can indirectly influence the level of discharge readiness through psychological resilience,providing theoretical support for psychological intervention research to improve the degree of discharge readiness of COPD patients.Methods:This study is a Cross-sectional survey,and the patients with COPD were selected from the department of respiratory Medicine and the Department of Geriatrics in the Yan’an University Affiliated Hospital and The Yan’an People’s Hospital from May 2021to December 2021 by convenience sampling method.The survey included general data（demographic and disease-related）,Readiness for Hospital Discharge Scale（RHDS）,Connor-Davidson Resilience Scale（CD-RISC）,Family APGAR Index（APGAR）.Epidata3.1 was used to set up the database for double entry,and SPSS 26.0 was used to process the data.Demography and disease-related data were described by frequency and composition,discharge readiness and resilience scores were described by（Χ±S）,and family function scores were described by M(P₂₅,P₇₅).Independent sample T test and one way ANOVA were used to analyze the differences of general data in discharge readiness scores,and multiple linear regression was used to analyze the influencing factors of discharge readiness in COPD patients.Pearson correlation and Spearman correlation were used to analyze the relationship between discharge readiness,mental resilience and family function in COPD patients.The mediation effect was analyzed by SPSS 26.0process macro program and verified by Bootstrap.Results:（1）The total score of discharge readiness of 262 patients with COPD was（69.21±13.77）,and the scores of three dimensions were adaptive ability（6.47±1.89）,personal status（5.36±1.71）and anticipatory support（5.19±1.88）.The total score of mental resilience was（50.68±9.82）,and the standardized scores of three dimensions were optimism（2.22±0.49）,tenacity（2.00±0.42）and strength（1.97±0.52）.The scores of family function ranged from 3 to 8,with median and quartile 8（6,9）and an average of7.39.The mean values of each dimension were fitness（1.48）,cooperation（1.11）,maturity（1.48）,affection（1.66）and intimacy（1.64）.（2）Independent sample T test and one way ANOVA show that the level of education,working status,place of residence,family per capita income,the types of health care,home and hospital level of distance,the course of the disease,pulmonary function,merging,chronic disease types,number of years the average hospitalization,the hospitalization days comparison between groups was statistically significant（P<0.05）.（3）Multiple linear regression results showed that medical insurance type,family per capita monthly income,lung function level,length of stay,psychological resilience,and family function were the influential factors for the discharge readiness of COPD patients.（4）The results of correlation analysis showed that there was a significant positive correlation between discharge readiness and mental resilience（r=0.372）.There was no correlation between expected support and mental resilience,but other dimensions of discharge readiness were significantly correlated with all dimensions of mental resilience（P<0.01）.There was a significant positive correlation between discharge readiness and family function（r_s=0.325）,and only a correlation between fitness and anticipatory support（P<0.01）.There was a significant positive correlation between family function and mental resilience（r_s=0.488）.There was no correlation between fitness and mental resilience,but other dimensions of family function were correlated with mental resilience（P<0.01）.（5）The mediating effect analysis showed that resilience had a partial mediating effect on the relationship between discharge readiness and family function,the effect value was 2.288,and the indirect effect accounted for 22.47%.Conclusion:（1）The discharge readiness of COPD patients is at a low level;Mental resilience is at a low level;Family functioning at a good level.（2）The influencing factors of discharge readiness of COPD patients included medical insurance type,per capita monthly income of family,lung function level,length of stay,mental resilience,and family function.（3）Discharge readiness of COPD patients was positively correlated with mental resilience and family function.The higher the level of mental resilience,the higher the degree of discharge readiness;The better the family function,the higher the discharge readiness.（4）Mental resilience partially mediates the relationship between discharge readiness and family function in COPD patients.Family function can not only directly affect discharge readiness,but also indirectly affect discharge readiness through mental resilience.