重度慢性阻塞性肺疾病患者姑息照护需求水平及其影响因素分析

doi:10.3969/j.issn.1006-6233.2019.02.024

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摘要 目的:探讨重度慢性阻塞性肺疾病(COPD)患者对于姑息照护的需求水平和影响因素。方法:选取2015年2月至2018年3月期间本院所收治重度COPD患者180例,采用姑息照护结局量表(POS量表)对患者的姑息照护需求水平进行评估,并采用HAD焦虑抑郁量表、KPS卡式功能量表、Borg量表对影响重度COPD患者POS量表评分的影响因素。结果:本次研究中,180例重度COPD患者POS量表评分平均为14.1±5.3分;单因素分析显示,性别、经济压力、病程、肺功能等级和合并症种类均是影响重度COPD患者姑息照护需求水平的相关因素,差异具有显著性(P<0.05);重度COPD患者的HAD评分、Borg评分同姑息照护需求水平呈明显正相关,KPS评分与姑息照护需求水平呈明显负相关,差异具有显著性(P<0.05);多因素分析结果显示,肺功能等级、合并症种类、HAD评分是影响重度COPD患者姑息照护需求水平的关键因素,同患者姑息照护需求水平呈明显正相关,差异具有显著性(P<0.05)。结论:重度COPD患者存在较高的姑息照护服务需求,其中,患者的肺功能等级、合并症种类、焦虑抑郁程度均是影响此类患者姑息照护需求水平的重要因素,临床应加强对此类患者姑息照护需求的评估,对患者病程进展程度密切把握,提高对患者舒适度和尊严的关注程度,以提高重度COPD患者的生活质量。

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	陈晓珊

关键词 ：重度慢性阻塞性肺疾病, 姑息照护, 需求水平, 影响因素

Abstract：Objective:To explore the level of demand and influencing factors for palliative care in patients with severe chronic obstructive pulmonary disease (COPD). Methods: A total of 180 patients with severe COPD were enrolled in our hospital from February 2015 to March 2018. The palliative care outcome scale (POS scale) was used to assess the level of palliative care needs, and the HAD anxiety and depression scale was used. Influencing factors of KPS card function scale and Borg scale on POS scale scores in patients with severe COPD. Results: In this study, 180 patients with severe COPD had an average POS score of 14.1 ± 5.3. Univariate analysis showed that gender, economic stress, duration of disease, pulmonary function, and comorbidities were all palliative care for patients with severe COPD. The correlation factors of the demand level were significantly different (P<0.05). The HAD score and Borg score of patients with severe COPD were positively correlated with the palliative care demand level. The KPS score was significantly negatively correlated with the palliative care demand level. The difference was significant. Sexuality (P<0.05); multivariate analysis showed that lung function grade, comorbidity type, and HAD score were the key factors affecting the level of palliative care in patients with severe COPD, and were significantly positively correlated with the level of palliative care needs of patients. Sex (P<0.05). Conclusion: Patients with severe COPD have higher palliative care services. Among them, the patient's lung function level, comorbidity type, anxiety and depression are important factors affecting the level of palliative care of such patients. Clinically, palliative care should be strengthened for such patients. The assessment of needs, the degree of progress of the patient's disease course is closely grasped, and the degree of attention to patient comfort and dignity is improved to improve the quality of life of patients with severe COPD.

Key words： Severe chronic obstructive pulmonary disease Palliative care Demand level Influencing factors

基金资助:四川省科技厅资助项目,(编号:2015013477)

引用本文:

陈晓珊. 重度慢性阻塞性肺疾病患者姑息照护需求水平及其影响因素分析[J]. 河北医学, 2019, 25(2): 265-268.
CHEN Xiaoshan. Analysis on the Level of Palliative Care Demand and the Influencing Factors in Patients with Severe Chronic Obstructive Pulmonary Disease. HeBei Med, 2019, 25(2): 265-268.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2019.02.024 或 http://www.hbyxzzs.cn/CN/Y2019/V25/I2/265

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