Abstract:

Objective To investigate the prevalence of social isolation among patients with chronic obstructive pulmonary disease and explore its multidimensional determinants based on social cognitive theory，providing evidence for developing targeted clinical interventions. Methods An explanatory mixed-methods longitudinal design was employed. Convenience sampling was used to select 231 chronic obstructive pulmonary disease patients hospitalized at a tertiary-level hospital in Qingdao，Shandong Province，from February to June，2025 for a cross-sectional survey. Quantitative research employed a general information questionnaire，the short form of the Lubben Social Network Scale，the Chronic Disease Self-Management Self-Efficacy Scale，the Social Influence Scale，and the Family Social Capital Scale. Binary logistic regression analysis was used to explore influencing factors. Qualitative research involved semi-structured interviews with 13 patients experiencing social isolation，and Colaizzi’s seven-step method was applied to analyze the data. A combined presentation method was used to synthesize the findings. Results A total of 223 valid questionnaires were collected，revealing a 38.57% prevalence of social isolation among chronic obstructive pulmonary disease patients. Quantitative findings revealed that age，duration of illness，self-care ability，current smoking status，self-efficacy，stigma associated with illness，and family social capital were significant factors influencing social isolation in chronic obstructive pulmonary disease patients（P<0.05）. Qualitative analysis identified 4 themes，including dual psychological and physiological impacts，bidirectional effects of self-care ability and smoking behavior，physical environmental constraints and inadequate social support networks，and cognitive-behavioral-environmental maladjustment. The quantitative and qualitative findings exhibited convergence，complementarity，and silence. Conclusion Social isolation among chronic obstructive pulmonary disease patients results from a triadic interaction among individual，behavioral，and environmental factors. Healthcare providers should develop comprehensive intervention strategies addressing these 3 dimensions.

Key words: Pulmonary Disease, Chronic Obstructive, Social Isolation, Social Cognitive Theory, Mixed-Methods Study, Nursing Care

摘要：

目的 了解慢性阻塞性肺疾病（简称慢阻肺）患者社会隔离的发生现状，并基于社会认知理论探讨其多维影响因素，为临床制订针对性干预方案提供参考。方法 采用混合研究中的解释性时序混合设计。通过便利抽样法，选取2025年2—6月在山东省青岛市某三级甲等医院住院治疗的231例慢阻肺患者进行调查，量性研究采用一般资料调查表、中文版社会网络量表简表、中文版慢性病管理自我效能感量表、简体中文版社会影响量表、家庭社会资本量表进行调查，并采用二元Logistic回归分析探究其影响因素；质性研究选取存在社会隔离的13例患者进行半结构式访谈，运用Colaizzi 7步分析法对资料进行分析；采用联合展示法对研究结果进行综合分析。结果 共回收有效问卷223份，慢阻肺患者社会隔离的发生率为38.57%。量性研究结果显示，年龄、患病年限、自理能力、当前是否吸烟、自我效能、病耻感、家庭社会资本是慢阻肺患者社会隔离的影响因素（P<0.05）。质性研究共提炼出4个主题：心理与生理的双重影响、自理能力与吸烟行为的双向作用、物理环境限制与社会支持网络不完善、认知-行为-环境适配失调。量性与质性研究结果存在收敛、互补和沉默等类型。结论 慢阻肺患者社会隔离是个人、行为与环境交互作用下的现象，医护人员应根据影响因素制订针对性的干预措施。

关键词: 肺疾病, 慢性阻塞性, 社会隔离, 社会认知理论, 混合研究, 护理