Status of disease perception in patients with interstitial pulmonary disease and COPD
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摘要:
目的 调查间质性肺疾病与慢性阻塞性肺疾病(简称慢阻肺)患者的疾病认知现状，为临床护理提供参考和依据。 方法 采用简单随机抽样方法选择2021年8月—2022年10月中日友好医院呼吸与危重症医学科病房收治的慢阻肺患者83例，间质性肺疾病患者85例，使用疾病感知问卷(IPQ-R)对患者进行调查。 结果 在“症状识别”中，间质性肺疾病与慢阻肺患者得分为(5.86±0.83)分、(5.87±0.85)分(t=0.066，P=0.947)；在“病因感知”中，2组患者得分为(52.88±0.98)分、(52.80±1.09)分(t=0.545，P=0.587), 差异均无统计学意义。在“对疾病和自身认知评价”中，与慢阻肺相比，间质性肺疾病患者认为自己的“病程”更长[(18.91±0.85)分 vs. (18.18±1.70)分，t=3.485，P=0.001]。在“周期性复发”“疾病预后”“个人控制信心”方面，间质性肺疾病患者得分低于慢阻肺患者[(14.11±1.39)分 vs. (15.19±1.36)分，t=5.130；(20.34±0.93)分 vs. (20.69±0.46)分，t=3.142；(16.12±1.15)分 vs. (16.49±0.67)分，t=2.566，均P＜0.05]。 结论 间质性肺疾病患者对疾病复发、预后方面的疾病认知水平要低于慢阻肺患者，医护人员要根据患者疾病感知的水平与特点，有针对性地实施临床护理干预。 Abstract:Objective To investigate the status quo of disease cognition in patients with interstitial lung disease and chronic obstructive pulmonary disease (COPD), and to provide reference and basis for clinical nursing. Methods A questionnaire survey was used to randomly select 83 patients with COPD and 85 patients with interstitial lung disease from the Department of Respiratory and Critical Care Medicine of China-Japan Friendship Hospital from August 2021 to October 2022. The patients were investigated by disease perception questionnaire (IPQ-R). Results In the dimension of "symptom recognition", the scores of patients with interstitial lung disease and COPD were (5.86±0.83) points, (5.87±0.85) points, t=0.066, P=0.947. In the dimension of "etiological perception", the scores of the two groups were (52.88±0.98) points, (52.80±1.09) points, t=0.545, P=0.587. Compared with COPD, patients with interstitial lung disease perceived their "disease course" to be longer [(18.91±0.85) points vs. (18.18±1.70) points, t=3.485, P=0.001]. In terms of "cyclical recurrence" "disease prognosis" "personal control confidence", patients with interstitial lung disease scored lower than those with COPD [(14.11±1.39) points vs. (15.19±1.36) points, t=5.130; (20.34±0.93) points vs. (20.69±0.46) points, t=3.142; (16.12±1.15) points vs. (16.49±0.67) points, t=2.566, all P < 0.05]. Conclusion Patients with interstitial pulmonary disease have a lower cognition level of disease recurrence and prognosis than patients with COPD. Medical staff should implement targeted clinical nursing interventions according to the level and characteristics of patients' disease perception. -
表 1 2组肺病患者一般资料比较[例(%)]
Table 1. Comparison of general data of patients with pulmonary disease in two groups [cases (%)]
组别 例数 性别 年龄 男性 女性 40岁及以下 41~50岁 51~60岁 61~70岁 71岁及以上 间质性肺疾病组 85 46(54.1) 39(45.9) 6(7.1) 18(21.1) 31(36.5) 20(23.5) 10(11.8) 慢阻肺组 83 49(59.0) 34(41.0) 9(10.8) 11(13.2) 37(44.6) 15(18.1) 11(13.3) 统计量 0.413a 3.558b P值 0.520 0.469 组别 例数 学历 患病时间 获取疾病知识途径 初中及以下 高中或中专 大专 本科及以上 ≥1年~＜3年 ≥3年~＜5年 ≥5年 医院宣教 媒体网络平台 间质性肺疾病组 85 25(29.4) 23(27.1) 27(31.8) 10(11.8) 44(51.8) 23(27.1) 18(21.1) 49(57.6) 36(42.4) 慢阻肺组 83 30(36.1) 25(30.1) 22(26.5) 6(7.2) 38(45.8) 24(28.9) 21(25.3) 53(63.9) 30(36.1) 统计量 1.820b 0.663b 0.679a P值 0.177 0.416 0.410 注：a为χ2值，b为Z值。 
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表 2 2组肺病患者疾病感知问卷得分情况比较(x±s，分)
Table 2. Comparison of disease perception questionnaire scores between two groups of pulmonary disease patients (x±s, points)
组别 例数 症状识别 对疾病和自身认知评价 病因感知 病程 周期性复发 预后 个人控制信心 疾病一致性 情感陈述 治疗信心 间质性肺疾病组 85 5.86±0.83 18.91±0.85 14.11±1.39 20.34±0.93 16.12±1.15 17.25±1.86 19.60±1.65 16.58±0.50 52.88±0.98 慢阻肺组 83 5.87±0.85 18.18±1.70 15.19±1.36 20.69±0.46 16.49±0.67 17.48±1.51 20.78±1.82 16.48±0.50 52.80±1.09 t值 0.066 3.485 5.130 3.142 2.566 0.901 4.424 1.226 0.545 P值 0.947 0.001 < 0.001 0.002 0.011 0.369 < 0.001 0.222 0.587
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表 3 2组肺病患者在症状识别维度方面前5项结果比较[例(%)]
Table 3. Comparison of the top 5 results in the symptom recognition dimension between two groups of pulmonary disease patients [cases (%)]
排序 症状名称 间质性肺疾病组(n=85) 症状名称 慢阻肺组(n=83) 1 呼吸困难 43(50.6) 呼吸困难 45(54.2) 2 疲乏 35(41.2) 气喘 40(48.2) 3 乏力 33(38.8) 睡眠困难 35(42.2) 4 胃部不适 25(29.4) 疲乏 30(36.1) 5 关节僵硬 23(27.1) 体重减轻 30(36.1)
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表 4 2组肺病患者在疾病和自身认知评价各维度得分最高项目比较[例(%)]
Table 4. Comparison of the highest-scoring items in each dimension of disease and self-perception evaluation between two groups of pulmonary disease patients [cases (%)]
维度 题目内容 间质性肺疾病组(n=85) 题目内容 慢阻肺组(n=83) 病程 IP3：我的病将持续很长时间 76(89.4) IP2：我的病不是暂时的，可能永久存在 78(93.9) 预后 IP7：我的病给我的生活带来严重后果 72(84.7) IP10：我的病给我带来沉重的经济负担 73(87.9) 个人控制信心 IP13：我的行为，能决定我的病情好转还是恶化 59(69.4) IP13：我的行为，能决定我的病情好转还是恶化 68(81.9) 治疗信心 IP19：能够改善我病情的治疗方法太少了 55(64.7) IP22：目前的治疗能够控制住我的病情 58(69.9) 疾病一致性 IP24：关于我的病，有些症状让我迷惑不解 45(52.9) IP28：我很清楚自己的病 56(67.4) 复发 IP31：我的病真是没法预测 43(50.6) IP30：我的症状反反复复 50(60.2) 情感陈述 IP37：得这种病让我很焦虑 40(47.1) IP34：每当想到我的病时，我就心烦意乱 45(54.2)
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表 5 2组肺病患者在患病原因维度方面前5项比较[例(%)]
Table 5. Comparison of the top 5 items in the disease etiology dimension between two groups of pulmonary disease patients [cases (%)]
排序 患病的可能原因 间质性肺疾病组(n=85) 患病的可能原因 慢阻肺组(n=83) 1 C18：我的免疫力下降 77(90.6) C15：吸烟 69(83.1) 2 C7：环境污染 69(81.1) C8：我自己的行为 63(75.9) 3 C15：吸烟 60(70.6) C11：操劳过度 55(66.3) 4 C3：细菌或病毒感染 57(67.1) C7：环境污染 51(61.4) 5 C8：我自己的行为 45(52.9) C18：我的免疫力下降 48(57.8)
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