Yeh Mei-Ling, Chen Hsing-Hsia, Liao Yu-Chien, Liao Wei-Yu
Graduate Institute of Integration of Traditional Chinese Medicine with Western Nursing, National Taipei College of Nursing, Taipei, Taiwan.
J Adv Nurs. 2004 Nov;48(4):342-50. doi: 10.1111/j.1365-2648.2004.03203.x.
Patients with chronic obstructive pulmonary disease usually experience gradual functional status degradation, especially dyspnoea, which may affect their daily activities and, eventually, quality of life. A full understanding of both their physiological and psychological functional status is therefore beneficial for effective treatment and helping patients regain or maintain control of their lives.
Based on a non-experimental research design, 138 patients to test a hypothesized model of functional status in patients with chronic obstructive pulmonary disease, using structural equation modelling, were recruited from a medical center. Data were collected using questionnaires, 6-minute walking distance measurement, and pulmonary function test results recorded in patients' medical records. The proposed functional status model incorporated the exogenous variables disease severity and dyspnoea, and the endogenous variables age, exercise tolerance, fatigue, depression, anxiety, health perception and functional performance. Structural equation modelling with the lisrel software was used to establish a functional status model with those exogenous and endogenous variables.
The results indicated a good fit between the proposed functional status model and the data collected [chi(2) = 8.84, P = 0.64, chi(2)/d.f. = 0.80, Goodness of Fit Index (GFI) = 0.98, adjusted GFI (AGFI) = 0.95, root mean square residual (RMR) = 0.04, Critical N (CN) = 384.26]. Coefficients for paths in the functional status model all demonstrated statistical significance.
The functional status model was shown to consist of functional performance, functional capacity and other concepts, including disease severity, dyspnoea, age, exercise tolerance, fatigue, depression, anxiety and health perception. These results can be used to develop a suitable functional status model for chronic obstructive pulmonary disease, and could act as a reference for formulating future strategies and intervention procedures for further development of functional status.
慢性阻塞性肺疾病患者通常会经历功能状态的逐渐退化，尤其是呼吸困难，这可能会影响他们的日常活动，并最终影响生活质量。因此，全面了解他们的生理和心理功能状态有利于进行有效的治疗，并帮助患者重新获得或维持对生活的掌控。
基于非实验性研究设计，从一家医疗中心招募了138名患者，以使用结构方程模型测试慢性阻塞性肺疾病患者功能状态的假设模型。通过问卷调查、6分钟步行距离测量以及患者病历中记录的肺功能测试结果收集数据。所提出的功能状态模型纳入了外生变量疾病严重程度和呼吸困难，以及内生变量年龄、运动耐力、疲劳、抑郁、焦虑、健康认知和功能表现。使用lisrel软件进行结构方程建模，以建立包含这些外生和内生变量的功能状态模型。
结果表明所提出的功能状态模型与收集到的数据拟合良好[卡方(2)=8.84，P=0.64，卡方(2)/自由度=0.80，拟合优度指数(GFI)=0.98，调整后GFI(AGFI)=0.95，均方根残差(RMR)=0.04，临界N(CN)=384.26]。功能状态模型中各路径的系数均具有统计学意义。
功能状态模型显示由功能表现、功能能力以及其他概念组成，包括疾病严重程度、呼吸困难、年龄、运动耐力、疲劳、抑郁、焦虑和健康认知。这些结果可用于开发适合慢性阻塞性肺疾病的功能状态模型，并可为制定未来策略和干预程序以进一步发展功能状态提供参考。
