慢性阻塞性肺疾病患者运动恐惧的调查研究

doi:10.3761/j.issn.0254-1769.2023.06.012

摘要/Abstract

摘要：

目的探讨COPD患者运动恐惧的发展轨迹及其影响因素。方法 2022年1月—7月，采用便利抽样法，选取在湖州市某三级甲等医院呼吸内科住院的216例COPD患者作为研究对象。采用恐动症Tampa评分表在患者出院时、出院后1、3、6个月时，评估其运动恐惧水平，采用潜变量增长模型对运动恐惧轨迹进行分类，并分析不同类别运动恐惧的影响因素。结果 COPD患者运动恐惧轨迹分为3个潜在类别，分别为低运动恐惧组（25.5%）、中运动恐惧组（46.8%）、高运动恐惧组（27.7%）。不同轨迹类别在年龄、病程、BMI、肺功能分级、文化程度、疼痛评分、曼彻斯特COPD疲劳量表得分、改良版呼吸困难量表得分方面的比较，差异有统计学意义（P<0.05）。结论 COPD患者出院6个月内，大部分患者的运动恐惧得到了改善，其运动恐惧存在群体异质性，护士应根据患者的运动恐惧轨迹及其影响因素，制订针对性的护理措施，降低患者的运动恐惧水平。

关键词: 慢性阻塞性肺疾病, 运动恐惧, 轨迹, 潜类别增长模型, 护理

Abstract:

Objective To explore the development trajectories of exercise fear and its influencing factors in COPD patients. Methods From January 2022 to July 2022，216 patients with COPD who were hospitalized in the respiratory department of a tertiary A hospital in Huzhou City were selected as subjects by convenience sampling method. The Tampa Scale of Kinesiophobia was used to evaluate their exercise fear level at the time of discharge，and 1 month，3 months and 6 months after discharge. The latent class growth model was used to classify the exercise fear trajectory，and the influencing factors of different types of exercise fear were analyzed. Results The trajectory of exercise fear in COPD patients was identified into 3 potential categories：low exercise fear group （25.5%），moderate exercise fear group（46.8%） and high exercise fear group（27.7%）. There were significant differences in age，course of disease，BMI，lung function，educational level，pain，fatigue and mMRC among different trajectory types（P<0.05）. Conclusion Within 6 months after discharge of COPD patients，most patients’ exercise fear has been effectively alleviated，and there is group heterogeneity in their exercise fear. Nurses should carry out targeted nursing measures according to the patients’ exercise fear trajectory and its influencing factors，in order to improve and reduce the patients’ exercise fear state.

Key words: COPD, Exercise Fear, Trajectory, Latent Class Growth Model, Nursing Care

梁发存, 刘梦如, 尹艳茹, 茹运新, 程晨, 薛蒙, 顾丽芳, 韩慧. 慢性阻塞性肺疾病患者运动恐惧的调查研究[J]. 中华护理杂志, 2023, 58(6): 721-726.

LIANG Facun, LIU Mengru, YIN Yanru, RU Yunxin, CHENG Chen, XUE Meng, GU Lifang, HAN Hui. Investigation on the development trajectories of exercise fear in patients with chronic obstructive pulmonary disease[J]. Chinese Journal of Nursing, 2023, 58(6): 721-726.

图/表 3

表1 COPD患者运动恐惧应用潜类别增长模型拟合情况

Table 1 Fitting of the LCGM of exercise fear in COPD patients

图1 COPD患者运动恐惧潜类别增长模型轨迹图注：T1为出院当天；T2为出院后1个月；T3为出院后3个月；T4为出院后6个月。

Figure 1 LCGM trajectory diagram of exercise fear in COPD patients

表2 不同因素对COPD患者运动恐惧水平的影响[例（百分比，%）]

Table 2 Influence of different factors on exercise fear level in COPD patients[cases，percentage（%）]

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