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疾病认知与应对方式决定慢性阻塞性肺疾病患者的生活质量。

Illness perceptions and coping determine quality of life in COPD patients.

作者信息

Tiemensma Jitske, Gaab Erin, Voorhaar Maarten, Asijee Guus, Kaptein Adrian A

机构信息

Psychological Sciences.

Health Sciences Research Institute, University of California, Merced, CA, USA.

出版信息

Int J Chron Obstruct Pulmon Dis. 2016 Aug 25;11:2001-7. doi: 10.2147/COPD.S109227. eCollection 2016.

Abstract

BACKGROUND

A key goal of chronic obstructive pulmonary disease (COPD) care is to improve patients' quality of life (QoL). For outcomes such as QoL, illness perceptions and coping are important determinants.

AIM

The primary aim was to assess the associations between illness perceptions, coping and QoL in COPD patients. A secondary aim was to compare illness perceptions and coping of patients with reference values derived from the literature.

PATIENTS AND METHODS

A total of 100 patients were included in the study. Patients were asked to complete the Brief Illness Perception Questionnaire (B-IPQ), the Utrecht Proactive Coping Competence scale (UPCC), and a QoL item. Correlations and linear regression models were used to analyze the data. Student's t-tests were used to compare patients with COPD with reference values derived from the literature.

RESULTS

Patients with better understanding of COPD utilized more proactive coping strategies (P=0.04). A more intense emotional response to COPD was related to less proactive coping (P=0.02). Patients who reported using more proactive coping techniques also reported to have a better QoL (P<0.01). Illness perceptions were also related to QoL: more positive illness perceptions were related to a better QoL (all P<0.05). Patients with COPD reported more negative illness perceptions than people with a common cold or patients with asthma (all P<0.01), but reported similar perceptions compared with patients with diabetes.

CONCLUSION

Patients with COPD reported a moderate QoL, but appeared to be proficient in proactive coping. Illness perceptions, coping, and QoL were all associated with each other. Patients reported more strongly affected illness perceptions compared to people with a cold and patients with asthma. We postulate that a self-management intervention targeting patients' illness perceptions leads to improved QoL.

摘要

背景

慢性阻塞性肺疾病(COPD)护理的一个关键目标是提高患者的生活质量(QoL)。对于生活质量等结果而言,疾病认知和应对方式是重要的决定因素。

目的

主要目的是评估COPD患者的疾病认知、应对方式与生活质量之间的关联。次要目的是将患者的疾病认知和应对方式与文献中的参考值进行比较。

患者与方法

共有100名患者纳入本研究。要求患者完成简短疾病认知问卷(B-IPQ)、乌得勒支积极应对能力量表(UPCC)以及一项生活质量项目。采用相关性分析和线性回归模型对数据进行分析。使用学生t检验将COPD患者与文献中的参考值进行比较。

结果

对COPD理解较好的患者采用了更多积极的应对策略(P = 0.04)。对COPD更强烈的情绪反应与较少的积极应对相关(P = 0.02)。报告使用更多积极应对技巧的患者也报告有更好的生活质量(P < 0.01)。疾病认知也与生活质量相关:更积极的疾病认知与更好的生活质量相关(所有P < 0.05)。COPD患者报告的疾病认知比感冒患者或哮喘患者更消极(所有P < 0.01),但与糖尿病患者报告的认知相似。

结论

COPD患者报告生活质量中等,但似乎善于积极应对。疾病认知、应对方式和生活质量相互关联。与感冒患者和哮喘患者相比,患者报告疾病认知受影响更大。我们推测,针对患者疾病认知的自我管理干预可改善生活质量。

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