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中文版老年人體力活動(dòng)量表在老年COPD患者中的應(yīng)用及體力活動(dòng)的影響因素分析

發(fā)布時(shí)間:2018-10-18 12:31
【摘要】:目的1.將中文版老年人體力活動(dòng)量表(PASE)引入到老年慢性阻塞性肺疾病患者中;2.調(diào)查老年慢性阻塞性肺疾病患者體力活動(dòng)的水平,并探索體力活動(dòng)的影響因素。方法選取2015年3月至2016年5月在天津市第一中心醫(yī)院門診接受治療的194例老年慢性阻塞性肺疾病患者作為研究對(duì)象。收集患者的一般資料;運(yùn)用中文版老年人體力活動(dòng)量表和國(guó)際體力活動(dòng)問(wèn)卷評(píng)估老年慢性阻塞性肺疾病患者的體力活動(dòng)狀況,運(yùn)用SF-36生活質(zhì)量量表評(píng)估患者的生活質(zhì)量,運(yùn)用慢性病自我效能量表評(píng)價(jià)患者的自我效能,運(yùn)用計(jì)步器測(cè)量患者的步數(shù),運(yùn)用DOSE指數(shù)評(píng)價(jià)患者的疾病嚴(yán)重程度。檢驗(yàn)中文版老年人體力活動(dòng)量表的心理學(xué)特征,包括測(cè)量信度、效度和測(cè)量誤差。信度的評(píng)定包括重測(cè)信度評(píng)定和內(nèi)部一致性信度評(píng)定。效度的評(píng)定包括內(nèi)容效度評(píng)定、同時(shí)效度評(píng)定、效標(biāo)關(guān)聯(lián)效度評(píng)定和結(jié)構(gòu)效度評(píng)定。測(cè)量誤差由測(cè)量的標(biāo)準(zhǔn)誤差、最小可測(cè)變化值及一致性界限范圍評(píng)價(jià)。采用便利抽樣的方法,研究對(duì)象選取了2016年5月至2016年10月在天津市第一中心醫(yī)院和天津市胸科醫(yī)院門診接受治療的慢性阻塞性肺疾病患者209例。收集患者的一般資料,運(yùn)用中文版老年人體力活動(dòng)量表、SF-36生活質(zhì)量量表、慢性病自我效能量表、醫(yī)院焦慮抑郁量表和多維度疲勞量表等評(píng)定患者的相關(guān)狀況。采用單因素分析檢驗(yàn)不同分類變量中的體力活動(dòng)水平的差異,采用相關(guān)性分析檢驗(yàn)各連續(xù)變量與體力活動(dòng)水平的相關(guān)性;采用多元線性逐步回歸分析,進(jìn)一步探討老年慢性阻塞性肺疾病患者體力活動(dòng)水平的影響因素。結(jié)果1.中文版老年人體力活動(dòng)量表的信效度檢驗(yàn)194例老年慢性阻塞性肺疾病患者參與研究,中文版PASE量表的Cronbach’sα系數(shù)為0.725;總體重測(cè)信度為0.980;條目水平的內(nèi)容效度指數(shù)為0.70~1.00,全體一致量表水平的內(nèi)容效度指數(shù)為0.70,平均量表水平的內(nèi)容效度指數(shù)為0.93;校標(biāo)關(guān)聯(lián)效度為0.578;同時(shí)效度為0.698;PASE量表與SF-36和SES6的相關(guān)系數(shù)分別為0.522和0.600,與mMRC評(píng)分和DOSE指數(shù)的相關(guān)系數(shù)分別為-0.444和-0.405。測(cè)量的標(biāo)準(zhǔn)誤差為6.96,最小可測(cè)變化值為19.29。2.老年慢性阻塞性肺疾病患者的體力活動(dòng)水平及影響因素分析209例老年慢性阻塞性肺疾病患者參與了研究,體力活動(dòng)水平得分為(71.29±51.44)分,低于正常老年人體力活動(dòng)水平。單因素分析結(jié)果顯示,社會(huì)人口學(xué)變量中,在職狀況、氧療狀況、mMRC評(píng)分、GOLD分級(jí)、是否患有哮喘、是否患有冠心病的患者的體力活動(dòng)水平的差異有統(tǒng)計(jì)學(xué)意義(P0.05);連續(xù)性變量中,生理機(jī)能、生理職能、情感職能、精力、社會(huì)功能、精神健康、一般健康狀況、SES6、抑郁、握力、起坐試驗(yàn)與體力活動(dòng)水平存在正相關(guān)(P0.05),年齡、吸煙、DOSE指數(shù)、焦慮、多維度疲勞量表MFI-20的五個(gè)維度(綜合性疲勞、體力疲勞、活動(dòng)減少、動(dòng)機(jī)下降、腦力疲勞)與體力活動(dòng)水平存在負(fù)相關(guān)(P0.05)。多元線性逐步回歸分析結(jié)果顯示:起坐試驗(yàn)、活動(dòng)減少、SES6、在職狀況和哮喘對(duì)體力活動(dòng)水平有影響,五個(gè)變量對(duì)應(yīng)的標(biāo)準(zhǔn)化偏回歸系數(shù)分別為0.448、-0.243、0.239、-0.133、0.122,可解釋體力活動(dòng)總變異的62.5%,結(jié)論中文版老年人體力活動(dòng)量表在老年慢性阻塞性肺疾病患者中具有良好的信度和效度,可以作為國(guó)內(nèi)老年慢性阻塞性肺疾病患者體力活動(dòng)水平的測(cè)量工具。老年慢性阻塞性肺疾病患者體力活動(dòng)水平相對(duì)較低,有待進(jìn)一步提高,其中下肢肌力、疲勞、自我效能、在職狀況是影響患者體力活動(dòng)水平的主要因素。故在今后的臨床工作中,應(yīng)加強(qiáng)對(duì)于患者體力活動(dòng)水平的關(guān)注,積極改善影響體力活動(dòng)水平的危險(xiǎn)因素,采取針對(duì)性的干預(yù)措施,改善患者的體力活動(dòng)現(xiàn)狀,進(jìn)而提高患者的生活質(zhì)量。
[Abstract]:Purpose 1. PASE was introduced into the elderly patients with chronic obstructive pulmonary disease (COPD). To investigate the level of physical activity in elderly patients with chronic obstructive pulmonary disease and to explore the influencing factors of physical activity. Methods 194 elderly patients with chronic obstructive pulmonary disease were selected from March 2015 to May 2016 in the first central hospital of Tianjin. collecting general information of patients, evaluating the physical activity status of elderly patients with chronic obstructive pulmonary disease by using the Chinese version of the physical fitness table and the international physical activity questionnaire, and evaluating the quality of life of the patients by using the SF-36 quality of life scale, Using the self-efficacy scale of chronic disease to evaluate the patient's self-efficacy, the patient's number of steps was measured by pedometer and the severity of the disease was evaluated by using the DOSE index. The psychological characteristics of the physical examination table of the old people in the Chinese version are examined, including the measurement reliability, the effect degree and the measurement error. Reliability evaluation includes retest reliability assessment and internal consistency reliability assessment. The evaluation of efficiency includes the evaluation of content validity, the evaluation of the same time validity, the correlation efficiency of the effect mark and the evaluation of the structure efficiency. The measurement error is evaluated by the measured standard error, the minimum detectable change value, and the consistency limit range. Methods 209 patients with chronic obstructive pulmonary disease were selected from May 2016 to October 2016 in the First Central Hospital of Tianjin and Tianjin Chest Hospital from May 2016 to October 2016. The general information of the patients was collected, and the related conditions of the patients were evaluated by using the Chinese version of the old man's physical examination table, SF-36 quality of life scale, chronic disease self-efficacy scale, hospital anxiety and depression scale and multi-dimensional fatigue scale. Using single factor analysis to test the difference of physical activity level in different classification variables, correlation analysis was used to examine the correlation between continuous variables and physical activity level, and multiple linear stepwise regression analysis was used. Objective To study the influence factors of physical activity level in elderly patients with chronic obstructive pulmonary disease (COPD). Result 1. In this paper, 194 elderly patients with chronic obstructive pulmonary disease participated in the study, and the Conbach's coefficient of validity of the Chinese version of the PASE Scale was 0.725, and the overall retest reliability was 0. 980; the content validity index of the entry level was 0. 70 ~ 1. 00, The content validity index of the level of all consensus scales was 0. 70, the content validity index of the average scale was 0. 93, the correlation efficiency of the school scale was 0. 578, and the correlation coefficients between the PASE scale and SF-36 and SES6 were 0. 522 and 0. 600, respectively. The correlation coefficients of the mMRC score and the DOSE index were -0. 444 and-0.405, respectively. The measured standard error is 6.96 and the minimum detectable change value is 19. 29. 2. In the elderly patients with chronic obstructive pulmonary disease, 209 elderly patients with chronic obstructive pulmonary disease participated in the study, and the level of physical activity was divided into (71.29/ 51. 44), which was lower than that of the normal elderly. The results of single-factor analysis showed that in the social demographic variables, the difference of physical activity level of patients with coronary heart disease was statistically significant (P0.05). Physical function, emotional function, energy, social function, mental health, general health status, SES6, depression, grip, sitting test and physical activity level were positively correlated (P0.05), age, smoking, DOSE index, anxiety, There was a negative correlation between the five dimensions of the multi-dimensional fatigue scale MFI-20 (comprehensive fatigue, physical fatigue, decreased activity, decreased motivation, mental fatigue) and physical activity level (P0.05). The results of multiple linear stepwise regression analysis showed that the standard deviation regression coefficients corresponding to five variables were 0. 448,-0.243, 0. 239,-0. 133, 0. 122, respectively, which could explain the 62. 5% of the total variance of physical activity. Conclusion The Chinese version of elderly patients with chronic obstructive pulmonary disease (COPD) has good reliability and efficacy, and can be used as a measuring tool for the level of physical activity in elderly patients with chronic obstructive pulmonary disease. The level of physical activity in elderly patients with chronic obstructive pulmonary disease is relatively low, which needs to be further improved, including lower limb muscle strength, fatigue, self-efficacy, and in-service condition is the main factor affecting the level of physical activity of patients. Therefore, in the future clinical work, attention should be given to the level of physical activity of the patient, the risk factors influencing the level of physical activity should be actively improved, the targeted intervention measures should be adopted to improve the current situation of physical activity of the patients, and the quality of life of the patients can be improved.
【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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