摘要
目的 调查老年慢阻肺住院患者自主性感知现状,分析自主性感知水平与急性加重再入院的关系,并探讨自主性感知水平的影响因素。方法 收集268例老年慢阻肺住院患者作为研究对象,随访6个月。采用中文版自主性感知量表(PEAS-SCV)评估自主性感知水平。调查老年慢阻肺住院患者PEAS-SCV评分情况。根据6个月再入院情况,将患者分为再入院组和非再入院组,比较两组PEAS-SCV评分。采用受试者工作曲线(ROC)分析PEAS-SCV总分对急性加重入院的预测价值。根据ROC分析中的最佳截断值,将患者分为高自主性感知水平组和低自主性感知水平组,采用生存分析中的Kaplan-Meier(K-M)分析自主性感知水平对急性加重再入院的影响。采用多元线性回归分析自主性感知水平的影响因素。结果 老年慢阻肺住院患者PEAS-SCV总分为(51.73±6.74)分,再入院组PEAS-SCV总分及各维度评分低于非再入院组(P<0.05)。ROC分析显示,PEAS-SCV总分预测急性加重再入院的曲线下面积(AUC)为0.793,K-M分析显示低自主性感知水平组急性加重再入院率高于高自主性感知水平组(P<0.05)。线性回归分析显示,病程(B=-3.132)、婚姻状况(B=-2.305)、合并其他慢性疾病(B=-2.370)、抑郁状态(B=-3.217)和经济困难(B=-1.919)是自主性感知水平的影响因素(P<0.05)。结论 老年慢阻肺住院患者自主性感知水平与急性加重再入院密切相关,病程、婚姻状况、合并其他慢性疾病、抑郁状态和经济困难均是其影响因素。
Objective To investigate the status of perception of autonomy in elderly hospitalized patients with chronic obstructive pulmonary disease(COPD),to analyze the relationship between perception of autonomy and acute exacerbation readmission,and to explore influencing factors for perception of autonomy.Methods 268 hospitalized elderly patients with COPD were collected as research subjects and they were followed up for 6 months.Simplied Chinese Version of the PEA Scale(PEAS-SCV)was used to assess perception of autonomy.PEAS-SCV scores of elderly hospitalized patients with COPD were investigated.According to the situation of readmission in 6 months,they were divided into the readmission group and the non-readmission group.PEAS-SCV scores between the two groups were compared.The predictive value of total PEAS-SCV score for acute exacerbation readmission was analyzed with receiver operating curve(ROC).According to the optimal cutoff value in ROC analysis,they were divided into the high level and low level of perception of autonomy groups.Kaplan Meier(K-M)in survival analysis was used to analyze the influence of perception of autonomy on acute exacerbation readmission.Multiple linear regression was used to analyze influencing factors for perception of autonomy in elderly hospitalized patients with COPD.Results The total PEAS-SCV score in elderly hospitalized patients with COPD was(51.73±6.74)points.The total score of dimensions in PEAS-SCV in the readmission group was lower than that in the non-readmission group(P<0.05).ROC analysis showed that the area under the curve(AUC)for prediction of total PEAS-SCV score for acute exacerbation readmission was 0.793,and K-M analysis showed that rate of acute exacerbation readmission in group with low level of perception of autonomy was higher than that in the group with high level of perception of autonomy(P< 0.05). Linear regression analysis showed that course of disease (B=-3.132), marital status (B=-2.305), concomitant chronic diseases (B=-2.370), depressive status (B=-3.217) and financial difficulties (B= -1.919) were influencing factors for level of perception of autonomy ( P <0.05). Conclusion The level of perception of autonomy in elderly hospitalized patients with COPD is closely related to acute exacerbation readmission. The course of disease, marital status, concomitant chronic diseases, depressive status and financial difficulties are all influencing factors for level of perception of autonomy.
作者
张艳琦
张文帅
余凯霞
胡雅男
王鑫
ZHANG Yanqi;ZHANG Wenshuai;YU Kaixia;HU Ya′nan;WANG Xin(Intensive Care Medicine Department,the First Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830054,China)
出处
《临床肺科杂志》
2023年第11期1687-1691,共5页
Journal of Clinical Pulmonary Medicine
基金
新疆维吾尔自治区自然科学基金(No.2022D01C479)。
关键词
老年
慢阻肺
自主性感知
急性加重
再入院
影响因素
elderly
chronic obstructive pulmonary disease
perception of autonomy
acute exacerbation
readmission
influencing factors
