Cai Yingying, Zhang Zeyi, Ren Xiaohe, Chen Ou
School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Department of Surgical Intensive Care Unit, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China.
J Clin Nurs. 2025 Aug;34(8):3297-3306. doi: 10.1111/jocn.17513. Epub 2025 Jan 30.
To investigate the relationship between self-care and quality of life (QOL) in patients with chronic obstructive pulmonary disease (COPD) and their caregivers.
A multicentre, cross-sectional study.
COPD patients and their caregivers were recruited from four tertiary hospitals in Jinan, Shandong Province, China from March to November 2022. Data collection included demographic and clinical characteristics, patients' self-care, caregivers' contribution to patient self-care, and QOL. Statistical analysis included descriptive statistics, paired t-tests, Pearson correlations and Actor-Partner Interdependence Model (APIM) analyses.
A total of 275 valid questionnaires were collected (patients: 67.6% male, mean age 70.5; caregivers: 58.5% female, mean age 54.2). APIM analyses revealed actor effects of self-care on QOL for both patients and caregivers, as well as partner effects indicating the influence of one's self-care on the partner's QOL.
This study elucidates the dyadic relationship between self-care and QOL in COPD patients and caregivers. Higher levels of self-care maintenance by both patients and caregivers were associated with improved physical and mental QOL. Conversely, increased self-care monitoring was correlated with reduced QOL for both patients and caregivers. No significant relationship was found between self-care management and QOL.
For healthcare professionals specialising in geriatric care, our research provides more valuable guidance for the nursing of COPD patients. While maintaining vigilance is essential for both COPD patients and caregivers, our study suggests that excessive monitoring may have adverse effects on QOL, though this impact may vary depending on the underlying need for monitoring. This underscores the importance of tailored interventions that balance necessary vigilance with the potential risks of over-monitoring. By carefully considering the motivations behind monitoring, professionals can better support both patients and caregivers, ultimately enhancing self-care, improving QOL and contributing to healthy ageing.
The STROBE checklist was used to report the present study.
During the research design phase, we conducted interviews with patients and caregivers to capture pertinent issues related to their daily self-care routines. This initial step allowed us to gain an understanding of the potential differences between patients' self-care levels and caregivers' contributions to patients' self-care, while also exploring the potential impact on their health. Prior to data collection, we conducted a pilot study to identify any shortcomings in the research design and made corresponding adjustments. The phrasing of questions in the questionnaire was refined based on the feedback from patients and caregivers. During the interpretation phase, we solicited feedback from a subset of patients and caregivers to further validate our findings, thereby enhancing the clarity and relevance of our results for the target audience.
探讨慢性阻塞性肺疾病(COPD)患者及其照护者的自我护理与生活质量(QOL)之间的关系。
一项多中心横断面研究。
于2022年3月至11月从中国山东省济南市的四家三级医院招募COPD患者及其照护者。数据收集包括人口统计学和临床特征、患者的自我护理、照护者对患者自我护理的贡献以及生活质量。统计分析包括描述性统计、配对t检验、Pearson相关性分析和主- 伙伴相互依赖模型(APIM)分析。
共收集到275份有效问卷(患者:男性占67.6%,平均年龄70.5岁;照护者:女性占58.5%,平均年龄54.2岁)。APIM分析显示,自我护理对患者和照护者的生活质量均有主效应,同时也存在伙伴效应,即一个人的自我护理对其伙伴生活质量的影响。
本研究阐明了COPD患者及其照护者自我护理与生活质量之间的二元关系。患者和照护者更高水平的自我护理维持与改善的身心健康相关。相反,自我护理监测的增加与患者和照护者生活质量的降低相关。未发现自我护理管理与生活质量之间存在显著关系。
对于专门从事老年护理的医护人员而言,我们的研究为COPD患者的护理提供了更有价值的指导。虽然保持警惕对COPD患者和照护者都至关重要,但我们的研究表明,过度监测可能对生活质量产生不利影响,不过这种影响可能因监测的潜在需求而异。这凸显了量身定制干预措施的重要性,即在必要的警惕性与过度监测的潜在风险之间取得平衡。通过仔细考虑监测背后的动机,专业人员可以更好地支持患者和照护者,最终增强自我护理、改善生活质量并促进健康老龄化。
本研究采用STROBE清单进行报告。
在研究设计阶段,我们对患者和照护者进行了访谈,以了解与他们日常自我护理常规相关的相关问题。这一初步步骤使我们能够了解患者自我护理水平与照护者对患者自我护理贡献之间的潜在差异,同时还能探索对他们健康的潜在影响。在数据收集之前,我们进行了一项预试验,以识别研究设计中的任何缺陷并做出相应调整。问卷中的问题措辞根据患者和照护者的反馈进行了完善。在解释阶段,我们征求了一部分患者和照护者的反馈,以进一步验证我们的研究结果,从而提高我们结果对目标受众的清晰度和相关性。