Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.
Department of Physiotherapy, Østfold Hospital Trust, Fredrikstad, Norway.
Int J Chron Obstruct Pulmon Dis. 2014;9:41-50. doi: 10.2147/COPD.S52700. Epub 2013 Dec 19.
Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disease with an increasing prevalence worldwide. Its potential consequences, including reduced function and reduced social participation, are likely to be associated with decreased health-related quality of life (HRQoL). However, illness perceptions and self-efficacy beliefs may also play a part in determining HRQoL in persons with COPD. The aim of this study was to explore the relationships between illness perceptions, self-efficacy, and HRQoL in a sample of persons with COPD in a longitudinal perspective. The context of the study was a patient education course from which the participants were recruited. Data concerning sociodemographic variables, social support, physical activity, illness perceptions, general self-efficacy, and HRQoL were collected before the course started and 1 year after completion. Linear regression was used in the analyses. The results showed that less consequences and less symptoms (identity) were associated with higher physical HRQoL (PCS) at baseline and at 1-year follow-up. Less emotional response was similarly associated with higher mental HRQoL (MCS) at both time points. Lower self-efficacy showed a borderline significant association with higher PCS at baseline, but was unrelated to MCS at both time points. Self-efficacy showed no influence on the associations between illness perceptions and HRQoL. In conclusion, the study showed that specific illness perceptions had a stable ability to predict HRQoL in persons with COPD, whereas self-efficacy did not. The associations between illness perceptions and HRQoL were not mediated by self-efficacy.
慢性阻塞性肺疾病（COPD）是一种全球性患病率不断增加的进行性呼吸系统疾病。其潜在后果，包括功能降低和社会参与减少，可能与健康相关生活质量（HRQoL）降低有关。然而，疾病认知和自我效能信念也可能在确定 COPD 患者的 HRQoL 方面发挥作用。本研究的目的是从纵向角度探讨 COPD 患者样本中疾病认知、自我效能与 HRQoL 之间的关系。研究背景是一个患者教育课程，参与者是从该课程中招募的。在课程开始前和完成后 1 年收集了有关社会人口统计学变量、社会支持、身体活动、疾病认知、一般自我效能和 HRQoL 的数据。分析中使用了线性回归。结果表明，在基线和 1 年随访时，较少的后果和较少的症状（身份）与较高的身体 HRQoL（PCS）相关。较少的情绪反应同样与两个时间点的较高心理 HRQoL（MCS）相关。较低的自我效能在基线时与较高的 PCS 呈边缘显著相关，但与两个时间点的 MCS 无关。自我效能对疾病认知与 HRQoL 之间的关系没有影响。总之，该研究表明，特定的疾病认知具有稳定的能力来预测 COPD 患者的 HRQoL，而自我效能则不然。疾病认知与 HRQoL 之间的关联不受自我效能的影响。
