Shi Hong, Zhao Zhen, Liu Huijun, Yang Rujie
Department of Clinical Nursing, Xiangya Hospital, Central South University, Changsha, People's Republic of China.
Department of Emergency treatment, West China Hospital of Sichuan University, Chengdu, People's Republic of China.
Clin Interv Aging. 2025 May 29;20:739-750. doi: 10.2147/CIA.S504600. eCollection 2025.
Chronic obstructive pulmonary disease (COPD) significantly affects elderly individuals, often leading to social isolation and impacting quality of life. Family caregivers play a crucial role but may experience compassion fatigue (CF), potentially exacerbating patient outcomes. This study investigates social isolation in elderly COPD patients and examines the impact of caregiver compassion fatigue.
We conducted a retrospective analysis of 200 elderly COPD patients from January 2018 to December 2022 at West China Hospital of Sichuan University. Participants were divided into poor prognosis (n = 109) and good prognosis (n = 91) groups based on outcomes within 90 days of admission. Caregiver compassion fatigue was assessed using the Professional Quality of Life Scale (ProQOL), categorizing patients into low (n = 125) and high (n = 75) caregiver fatigue groups. Social isolation was measured using the Generalized Alienation Scale (GAS) and the Multidimensional Scale of Perceived Social Support (MSPSS). Patient outcomes included pulmonary function tests, the 6-Minute Walk Test (6MWT), and psychological assessments using the Hospital Anxiety and Depression Scale (HADS), Connor-Davidson Resilience Scale (CD-RISC), and the Satisfaction with Life Scale (SWLS).
No significant demographic differences were observed between GP and PP groups. The PP group exhibited higher GAS scores ( = 0.017) and lower MSPSS scores ( = 0.045), indicating greater social isolation. Caregivers of PP patients reported higher compassion fatigue and burnout levels ( = 0.007; = 0.003). Elevated caregiver compassion fatigue correlated with poorer patient outcomes, including decreased exercise tolerance ( = 0.021) and increased anxiety and depression ( = 0.008 and = 0.045, respectively). Lower resilience and life satisfaction scores were observed in patients with caregivers experiencing high compassion fatigue, highlighting the impact on psychological well-being.
Elderly COPD patients often experience significant social isolation, exacerbated by high levels of caregiver compassion fatigue.
慢性阻塞性肺疾病（COPD）对老年人有显著影响，常导致社会隔离并影响生活质量。家庭照顾者起着关键作用，但可能会经历同情疲劳（CF），这可能会使患者的预后恶化。本研究调查老年COPD患者的社会隔离情况，并探讨照顾者同情疲劳的影响。
我们对2018年1月至2022年12月在四川大学华西医院的200例老年COPD患者进行了回顾性分析。根据入院90天内的预后情况，将参与者分为预后不良组（n = 109）和预后良好组（n = 91）。使用职业生活质量量表（ProQOL）评估照顾者的同情疲劳，将患者分为照顾者疲劳程度低的组（n = 125）和高的组（n = 75）。使用广义疏离感量表（GAS）和多维感知社会支持量表（MSPSS）测量社会隔离。患者的预后包括肺功能测试、6分钟步行试验（6MWT），以及使用医院焦虑抑郁量表（HADS）、康纳-戴维森韧性量表（CD-RISC）和生活满意度量表（SWLS）进行的心理评估。
在预后良好组和预后不良组之间未观察到显著的人口统计学差异。预后不良组的GAS得分较高（P = 0.017），MSPSS得分较低（P = 0.045），表明社会隔离程度更高。预后不良患者的照顾者报告了更高的同情疲劳和倦怠水平（P = 0.007；P = 0.003）。照顾者同情疲劳程度升高与患者预后较差相关，包括运动耐力下降（P = 0.021）以及焦虑和抑郁增加（分别为P = 0.008和P = 0.045）。在照顾者同情疲劳程度高的患者中，观察到较低的韧性和生活满意度得分，突出了对心理健康的影响。
老年COPD患者常经历显著的社会隔离，照顾者高度的同情疲劳会加剧这种情况。
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