关键词: 肺疾病，慢性阻塞性, 症状负担, 疾病感知, 网络分析, 护理

Abstract:

Objective Exploring influencing factors of symptom burden in patients with AECOPD and the underlying mechanisms of its association with illness perception，so as to provide a reference for clinical nursing practice. Methods A convenience sampling method was used to recruit COPD patients from the Department of Respiratory Medicine and Geriatrics at a tertiary hospital in Shenzhen between November 2024 and August 2025. Data were collected using a sociodemographic questionnaire，the Brief Illness Perception Questionnaire，and the COPD Assessment Test. Hierarchical regression analysis was conducted to examine the impact of illness perception on symptom burden among patients with acute exacerbations of chronic obstructive pulmonary disease. Network models were then constructed using R version 4.4.2 to identify core and bridge nodes and to evaluate the stability of the network structure. Results A total of 300 questionnaires were distributed，with 272 valid responses collected. The symptom burden score for patients with acute exacerbation of chronic obstructive pulmonary disease was （18.90±4.46），and the disease perception score was （45.24±6.80）. The results of hierarchical linear regression analysis showed that illness perception independently explained 5.4% of the total variance in symptom burden among patients with acute exacerbations of chronic obstructive pulmonary disease. Network analysis identified sputum production as the core symptom burden in these patients. Patients’ concern about their illness emerged as the central illness perception and served as a key bridge node linking symptom burden and illness perception. Conclusion The symptom burden of patients with acute exacerbation of chronic obstructive pulmonary disease was at a moderate level，while negative illness perception was at a moderate-to-high level. Symptom burden and illness perception were interrelated，and the mechanisms underlying the associations between different symptom burdens and illness perception varied. It is recommended that healthcare professionals consider illness perception as a key entry point for psychological interventions to alleviate patients’ concerns and improve their symptom burden.

Key words: Pulmonary Disease，Chronic Obstructive, Symptom Burden, Illness Perception, Network Analysis, Nursing Care