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

摘要：

目的 探索慢性阻塞性肺疾病急性加重期患者症状负担的影响因素，以及其与疾病感知间的内部关联机制，为临床护理实践提供参考。 方法 采用方便抽样的方法，选取2024年11月—2025年8月在深圳市某三级甲等医院呼吸内科、老年科住院的慢性阻塞性肺疾病急性加重期患者作为调查对象，使用一般资料调查问卷、简易疾病感知量表、慢性阻塞性肺疾病评估测试问卷进行调查。通过分层回归探究疾病感知对慢性阻塞性肺疾病急性加重期患者症状负担的影响，应用R 4.4.2软件构建二者的网络模型，识别核心及桥梁节点，并评估网络结构稳定性。 结果 共发放问卷300份，回收有效问卷272份。慢性阻塞性肺疾病急性加重期患者症状负担得分为（18.90±4.46）分，疾病感知得分为（45.24±6.80）分。分层线性回归分析结果显示，疾病感知能独立解释慢阻肺急性加重期患者症状负担总变异的5.4%。网络分析显示，咳痰是慢性阻塞性肺疾病急性加重期患者的核心症状负担，患者对疾病的担忧程度是核心疾病感知，且作为连接症状负担与疾病感知的关键桥梁节点。 结论 慢性阻塞性肺疾病急性加重期患者的症状负担处于中等水平，负性疾病感知为较高，负性疾病感知会加重患者的症状负担。症状负担与疾病感知相互关联，且不同症状负担与疾病感知间的作用机制存在差异。建议医护人员可将疾病感知作为心理干预切入点，缓解患者的担忧情绪，改善其症状负担。

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