本文選題：慢性阻塞性肺疾病 + 焦慮��； 參考：《天津醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的1.對(duì)呼吸系統(tǒng)疾病焦慮量表(Anxiety Inventory for Respiratory disease,AIR)進(jìn)行翻譯、回譯及文化調(diào)試,并結(jié)合我國(guó)的文化背景建立中文版呼吸系統(tǒng)疾病焦慮量表AIR。2.評(píng)價(jià)中文版AIR量表的信度和效度,并探討量表在評(píng)估我國(guó)慢性阻塞性肺疾病(COPD)患者焦慮的適用性。3.初步評(píng)估COPD患者的焦慮現(xiàn)狀并探討COPD患者焦慮的影響因素。方法2015年10月至2016年4月,對(duì)英文版AIR量表進(jìn)行翻譯、回譯及文化調(diào)試,邀請(qǐng)護(hù)理專家和雙語(yǔ)專家對(duì)量表的內(nèi)容進(jìn)行修訂,形成中文版AIR量表。抽取天津市胸科醫(yī)院和天津市第一中心醫(yī)院的呼吸科門(mén)診COPD患者181例作為研究對(duì)象,對(duì)中文版AIR量表進(jìn)行信度和效度檢驗(yàn)。量表的信度使用內(nèi)部一致性檢驗(yàn)和重測(cè)信度進(jìn)行評(píng)價(jià),本研究采用Cronbach'sα系數(shù)對(duì)量表進(jìn)行內(nèi)部一致性檢驗(yàn),采用重測(cè)信度進(jìn)行量表的穩(wěn)定性分析。量表的效度主要使用內(nèi)容效度、聚合效度和結(jié)構(gòu)效度進(jìn)行檢驗(yàn),量表的內(nèi)容效度包括條目水平的內(nèi)容效度及量表水平的內(nèi)容效度;聚合效度主要是通過(guò)測(cè)量AIR量表與醫(yī)院焦慮抑郁量表(HADS)、COPD評(píng)估測(cè)試(CAT)及日常生活能力量表(ADLS)的相關(guān)系數(shù)檢驗(yàn);結(jié)構(gòu)效度采用驗(yàn)證性因子分析進(jìn)行驗(yàn)證。2016年4月至2016年11月從天津市胸科醫(yī)院和天津市第一中心醫(yī)院呼吸科門(mén)診另抽取COPD患者226例進(jìn)行問(wèn)卷調(diào)查,通過(guò)一般資料調(diào)查表收集研究對(duì)象的社會(huì)人口學(xué)資料和疾病相關(guān)資料,采用中文版AIR量表、COPD評(píng)估測(cè)試(CAT)、日常生活能力量表(ADLS)、社會(huì)支持評(píng)定量表(SSRS)、APGAR家庭功能評(píng)估量表調(diào)查COPD患者的焦慮狀況、生活質(zhì)量和功能狀態(tài)以及社會(huì)家庭功能狀況。了解我國(guó)COPD患者的焦慮現(xiàn)狀,探討影響我國(guó)COPD患者焦慮狀況的因素。本研究采用SPSS19.0統(tǒng)計(jì)包軟件對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析。描述性統(tǒng)計(jì)、t檢驗(yàn)、單因素方差分析、Pearson/Spearman相關(guān)分析和多元線性回歸分析作為本研究的主要統(tǒng)計(jì)方法。結(jié)果1.AIR量表的漢化及心理學(xué)測(cè)量181例COPD患者納入并參與了本項(xiàng)研究,經(jīng)過(guò)對(duì)量表的翻譯、回譯及文化調(diào)試,中文版AIR量表共包括10個(gè)條目。該量表顯示較好的重測(cè)信度和內(nèi)部一致性信度,量表的重測(cè)相關(guān)系數(shù)為0.90,整個(gè)量表的Cronbach'sα系數(shù)為0.91;量表的內(nèi)容效度中條目水平的(item-level CVI,I-CVI)、平均量表水平的(scale-level CVI/Average,S-CVI/Ave)、全體一致性量表水平的(scale-level CVI//Universal Agreement,S-CVI/UA)內(nèi)容效度指數(shù),所得結(jié)果分別為0.89~1,0.90和0.98。聚合效度經(jīng)相關(guān)性分析顯示,與醫(yī)院焦慮抑郁量表(HADS)的相關(guān)系數(shù)為0.83,與COPD評(píng)估測(cè)試(CAT)的相關(guān)系數(shù)為0.44,與日常生活能力量表(ADLS)的相關(guān)系數(shù)為0.36,均顯示良好的相關(guān)性(P0.01);驗(yàn)證性因子分析結(jié)果顯示,量表二因素(廣泛性焦慮和驚恐障礙)模型擬合良好,各項(xiàng)指標(biāo)較好,修正后標(biāo)準(zhǔn)化二因素模型的卡方自由度比值(CMIN/DF)、擬合優(yōu)度指數(shù)(GFI)、殘差均方和平方根(RMR)、近似誤差均方根(RMSEA)、增值擬合指數(shù)(IFI)、非歸準(zhǔn)適配指數(shù)(TLI)、比較擬合指數(shù)(CFI)分別為2.011、0.93、0.01、0.07、0.97、0.95、0.97,提示中文版AIR量表結(jié)構(gòu)效度較好。2.COPD患者的焦慮狀況、單因素及多因素分析研究最終完成對(duì)226例患者有效資料的收集。患者中男性152例(67.3%),女性74例(32.7%),平均年齡為67.19±8.34歲。AIR量表總分最小值為0分,最大值為22分,焦慮分6(3-10)分。單因素分析結(jié)果顯示,社會(huì)人口學(xué)資料中:文化程度、對(duì)疾病了解情況、經(jīng)濟(jì)負(fù)擔(dān)、運(yùn)動(dòng)狀況對(duì)患者焦慮得分有統(tǒng)計(jì)學(xué)意義(P0.05);疾病相關(guān)資料中:近一年加重次數(shù)、呼吸困難程度和COPD分級(jí)對(duì)患者焦慮得分差異有統(tǒng)計(jì)學(xué)意義(P0.05);連續(xù)性變量Spearman相關(guān)分析中:焦慮與生活質(zhì)量(CAT評(píng)分)、家庭功能(APGAR家庭功能評(píng)分)、社會(huì)支持(SSRS評(píng)分)和日常生活能力(ADLS)的相關(guān)性有統(tǒng)計(jì)學(xué)意義(P0.001)。以患者焦慮得分為因變量進(jìn)行多元線性回歸分析結(jié)果顯示:COPD分級(jí)、經(jīng)濟(jì)負(fù)擔(dān)、疾病了解情況、CAT評(píng)分、家庭功能評(píng)分進(jìn)入以AIR量表總分為因變量的回歸方程,偏回歸系數(shù)分別為0.693、0.838、-1.234、0.329、-0.653,5個(gè)變量共解釋了焦慮總變異的52.6%。結(jié)論(1)本研究引進(jìn)并漢化英文版AIR量表,并將中文版AIR量表應(yīng)用于中國(guó)慢阻肺患者中進(jìn)行量表的心理學(xué)檢測(cè)。結(jié)果表明中文版AIR量表在慢性阻塞性肺疾病患者中具有良好的信度和效度,可以用于我國(guó)慢性阻塞性肺疾病患者焦慮狀況的初步評(píng)估。該量表?xiàng)l目較少,并且內(nèi)容較為簡(jiǎn)單可靠,患者相對(duì)容易理解,方便臨床測(cè)試者使用,應(yīng)用于臨床COPD患者的焦慮初步評(píng)估,可以幫助醫(yī)護(hù)人員及時(shí)了解慢性阻塞性肺疾病患者的焦慮狀況并作出及時(shí)的干預(yù)治療。(2)我國(guó)慢性阻塞性肺疾病患者的焦慮得分低于源量表作者對(duì)英國(guó)COPD患者評(píng)估的得分情況,焦慮水平較低。其中,COPD分級(jí)、經(jīng)濟(jì)負(fù)擔(dān)、疾病了解情況、生活質(zhì)量、家庭功能狀況是患者焦慮的主要影響因素。臨床應(yīng)重視慢性阻塞性肺疾病患者的焦慮狀況,將焦慮評(píng)估作為日常常規(guī)評(píng)估之一,在門(mén)診初步評(píng)估患者的焦慮狀況,及早發(fā)現(xiàn)患者的心理問(wèn)題,從而及時(shí)進(jìn)行針對(duì)性的干預(yù)治療,改善患者的疾病狀況,提高患者的生活質(zhì)量。
[Abstract]:Objective 1. Anxiety Inventory for Respiratory disease (AIR) was translated, translated, and culture debugged, and the Chinese version of respiratory system disease anxiety scale AIR.2. was established to evaluate the reliability and efficacy of the Chinese version of the Chinese version of the respiratory system disease anxiety scale, and the scale was used to evaluate the chronic obstructive pulmonary disease in China. The applicability of anxiety in patients with disease (COPD).3. preliminarily assessed the anxiety status of COPD patients and explored the influencing factors of anxiety in COPD patients. Methods from October 2015 to April 2016, the English version of the AIR scale was translated, translated and tested, and the contents of the scale were revised by nursing experts and bilingual experts to form a Chinese version of the AIR scale. The reliability and validity of the Chinese version of the 181 COPD patients were tested in the Department of respiration of Tianjin Thoracic Hospital and the Department of respiration in the Department of respiration. The reliability of the Chinese version was tested by the internal consistency test and retest reliability. The Cronbach's alpha coefficient was used to test the internal consistency of the scale. The validity of the scale is mainly tested by content validity, aggregation validity and structural validity. The content validity of the scale includes the content validity of the entry level and the content validity of the scale. The aggregation validity is mainly by the measurement of the AIR scale and the hospital anxiety and Depression Scale (HADS), and the COPD assessment Test (CAT) and daily living capacity scale (ADLS) correlation coefficient test; structural validity using confirmatory factor analysis to verify 226 cases from April to November 2016 from Tianjin Thoracic Hospital and Department of respiration in Department of respiration, Department of respiration, 226 cases were investigated, and the research objects were collected through the general data questionnaire. The data of social demography and disease related information, using the Chinese version of the AIR scale, the COPD assessment test (CAT), the daily living capacity scale (ADLS), the social support assessment scale (SSRS), and the APGAR family function assessment scale (APGAR) to investigate the anxiety status of the COPD patients, the quality of life and function and the social family function, and to understand the COPD patients in China. The factors affecting anxiety status of COPD patients in China are discussed. This study uses SPSS19.0 statistical package software to analyze the data. Descriptive statistics, t test, single factor variance analysis, Pearson/Spearman correlation analysis and multiple linear regression analysis are used as the main statistical methods in this study. Results the 1.AIR scale is sinicized and heart of the heart. 181 cases of COPD were included and participated in this study. After the translation of the scale, translation and cultural debugging, the Chinese version of the AIR scale included a total of 10 items. The scale showed good retest reliability and internal consistency reliability, the retest correlation coefficient of the scale was 0.90, the Cronbach's alpha coefficient of the whole scale was 0.91; the content of the scale was content. The validity of the item level (item-level CVI, I-CVI), the average scale level (scale-level CVI/Average, S-CVI/Ave), the content validity index of the whole consistency scale (scale-level CVI//Universal Agreement, S-CVI/UA), and the results of 0.89~ 1,0.90 and the correlation analysis of aggregation validity, respectively, and the anxiety and depression of the hospital. The correlation coefficient of the scale (HADS) was 0.83, the correlation coefficient of the COPD assessment test (CAT) was 0.44, and the correlation coefficient of the daily living capacity scale (ADLS) was 0.36, which showed good correlation (P0.01). The results of confirmatory factor analysis showed that the scale of the scale factor (broad sexual anxiety and panic disorder) model was well fitted, the indexes were better, the correction was better. After standardized two factor model, the chi square degree of freedom ratio (CMIN/DF), fit goodness index (GFI), residual mean square and square root (RMR), approximate error mean square root (RMSEA), value added fitting index (IFI), non return quasi fitness index (TLI), and comparison fitting index (CFI) respectively 2.011,0.93,0.01,0.07,0.97,0.95,0.97, suggesting the structure validity of the Chinese version AIR scale The anxiety status of better.2.COPD patients, single factor and multi factor analysis study finally completed the collection of effective data for 226 patients. 152 (67.3%) and 74 women (32.7%) in the patients, the minimum of the average age of 67.19 + 8.34 years was 0, the maximum was 22, and the anxiety was 6 (3-10). The single factor analysis showed that the society was a society. In demographic data, the degree of culture, the understanding of disease, the economic burden, and the exercise status were statistically significant (P0.05). In the related data of disease, the times of aggravation, the degree of dyspnea and the classification of COPD were statistically significant (P0.05) for the anxiety score of the patients (P0.05), and in the Spearman correlation analysis of continuous variables: Anxiety The correlation between the family function (CAT score), the family function (APGAR family function score), the social support (SSRS score) and the daily living ability (ADLS) was statistically significant (P0.001). The multivariate linear regression analysis of the patient's anxiety scores showed that the COPD grade, the economic burden, the disease understanding, the CAT score, and the family function evaluation. The regression equation was divided into the AIR total score as the dependent variable, and the partial regression coefficient was 0.693,0.838, -1.234,0.329, and -0.653,5 respectively explained the 52.6%. conclusion of the total variation of anxiety (1) this study introduced and sinicate the English version of the English version of the AIR scale, and applied the Chinese version of the AIR scale to the psychological test of the scale of Chinese chronic obstructive pulmonary disease. The results show that the Chinese version of the AIR scale has good reliability and validity in the patients with chronic obstructive pulmonary disease. It can be used for the preliminary assessment of anxiety in patients with chronic obstructive pulmonary disease in China. The scale of the scale is less, and the content is relatively simple and reliable. The patient is relatively easy to solve, and it is convenient for clinical testing people to use and apply to clinical COPD. The initial assessment of the patient's anxiety can help the medical staff understand the anxiety status of the patients with chronic obstructive pulmonary disease and make timely intervention. (2) the scores of anxiety in the patients with chronic obstructive pulmonary disease in China are lower than that in the assessment of COPD patients in the UK, and the level of anxiety is low. Among them, the COPD classification is the economy. Burden, understanding of disease, quality of life and family function are the main factors that affect the anxiety of patients. We should pay attention to the anxiety status of patients with chronic obstructive pulmonary disease, take the assessment of anxiety as one of the routine routine assessment, evaluate the anxiety of the patients in the outpatient, and find out the psychological problems of the patients in a timely manner, so that the needles will be carried out in time. Sexual intervention therapy can improve the condition of patients and improve their quality of life.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R473.5

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