Medinas Amorós María Magdalena, Más Tous Carmen, Renom Sotorra Feliu
Unidad de Psicología, Hospital Joan March, Complejo Hospitalario de Mallorca, Bunyola, Mallorca, España.
Rev Esp Geriatr Gerontol. 2009 May-Jun;44(3):130-6. doi: 10.1016/j.regg.2009.01.006. Epub 2009 May 13.
Studies of stress during hospitalization have mainly focused on patients admitted for acute problems. However, stress and its relationship with health-related quality of life (HRQOL) has yet to be described in chronic and elderly patients. The objective of this paper is to study the presence of stress and coping strategies in patients with chronic obstructive pulmonary disease (COPD) in a public geriatric hospital and its relationship with HRQL prior to admission, COPD severity, and dyspnea stage.
Fifty-one patients with a diagnosis of COPD were evaluated in the Joan March Hospital (Balearic Islands, Spain) by means of the Hospital Stress Rating Scale, the Dyspnea Scale, the Nottingham Health Profile, and a list of coping strategies.
Low stress levels were found in elderly hospitalized COPD patients. Stress levels were independent of the COPD severity stage. Patients with mild dyspnea had higher stress levels than those with the most severe dyspnea (p<0.05). Patients with poor HRQOL before admission had higher stress levels during hospitalization (p<0.05). The most prevalent coping strategies in these hospitalized patients were related to avoidance.
The stress generated during hospitalization in elderly COPD patients was related to prior psychosocial conditions (HRQOL) and had a greater effect on patients with greater functional independence.
住院期间的压力研究主要集中在因急性问题入院的患者身上。然而，慢性疾病患者和老年患者的压力及其与健康相关生活质量（HRQOL）的关系尚未得到描述。本文的目的是研究一家公立老年医院中慢性阻塞性肺疾病（COPD）患者的压力状况和应对策略，以及其与入院前的HRQL、COPD严重程度和呼吸困难阶段的关系。
在西班牙巴利阿里群岛的琼·马尔奇医院，采用医院压力评定量表、呼吸困难量表、诺丁汉健康量表和一份应对策略清单，对51名诊断为COPD的患者进行了评估。
老年住院COPD患者的压力水平较低。压力水平与COPD严重程度阶段无关。轻度呼吸困难患者的压力水平高于重度呼吸困难患者（p<0.05）。入院前HRQOL较差的患者在住院期间的压力水平较高（p<0.05）。这些住院患者中最常见的应对策略与回避有关。
老年COPD患者住院期间产生的压力与先前的心理社会状况（HRQOL）有关，对功能独立性较强的患者影响更大。
