肺康复过程中慢性阻塞性肺疾病相关焦虑症状的变化:一项前瞻性定量和定性研究。

IF 1.3 Q3 REHABILITATION
Frontiers in rehabilitation sciences Pub Date : 2024-08-07 eCollection Date: 2024-01-01 DOI:10.3389/fresc.2024.1428893
Ingeborg Farver-Vestergaard, Eva Holmegaard Buksted, Dorthe Sørensen, Sune Jonstrup, Henrik Hansen, Camilla Fischer Christiansen, Anders Løkke
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引用次数: 0

摘要

背景:慢性阻塞性肺病患者的恐惧回避会对肺康复(PR)结果产生不利影响,因此必须加以解决。这项前瞻性研究考察了慢性阻塞性肺病相关焦虑症状在肺康复计划过程中的变化和管理情况:方法:2022 年 1 月至 12 月期间,在丹麦韦勒市接受为期 9 周肺康复治疗的慢性阻塞性肺病患者在接受肺康复治疗前后均完成了六分钟步行测试 (6MWT) 和以下问卷调查:慢性阻塞性肺疾病焦虑问卷 20 项版本 (CAF-R),测量与慢性阻塞性肺疾病相关的焦虑;慢性阻塞性肺疾病评估测试 (CAT),测量与慢性阻塞性肺疾病相关的残疾;12 项短式健康调查 (SF-12),测量与健康相关的生活质量 (HR-QoL);社会人口学和疾病相关信息。公关后,一部分患者参加了半结构化访谈,以了解他们在公关期间如何处理与慢性阻塞性肺疾病相关的焦虑。通过 t 检验和相关性分析对慢性阻塞性肺病相关焦虑的前后评估及其他 PR 结果进行了分析。采用主题分析法对定性访谈进行分析:共有 72 名慢性阻塞性肺病患者(平均 ± SD 年龄为 71 ± 8 岁,53% 为女性)参与了研究,其中 13 人参加了定性访谈。观察发现,从公关前到公关后,慢性阻塞性肺病相关焦虑症患者的焦虑程度明显降低,但影响较小(Cohen's d = 0.32; p = 0.018)。慢性阻塞性肺病相关焦虑的减少与慢性阻塞性肺病相关残疾、心率-质量-生活质量或功能锻炼能力的改善无关。定性研究结果确定了四种焦虑管理策略,即 "计划"、"解决问题"、"接受 "和 "面对",这些策略受到与医护人员和共同患者的互动以及患者自身认知的影响:与慢性阻塞性肺病相关的焦虑症状在 PR 后有所减轻,这可能是通过使用各种管理策略实现的。这些策略似乎受到公关项目中互动因素的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Changes in COPD-related anxiety symptoms during pulmonary rehabilitation: a prospective quantitative and qualitative study.

Background: Fear-avoidance in COPD can have detrimental effects on pulmonary rehabilitation (PR) outcomes and is therefore important to address. This prospective study examined changes in and management of COPD-related anxiety symptoms over the course of a PR program.

Methods: Patients with COPD referred to 9-weeks of PR in the municipality of Vejle, Denmark from January to December 2022 completed a six-minute walk test (6MWT) and the following questionnaires, both before and after PR: COPD Anxiety Questionnaire 20-item version (CAF-R), measuring COPD-related anxiety; COPD Assessment Test (CAT), measuring COPD-related disability; 12-Item Short-Form Health Survey (SF-12), measuring health-related quality of life (HR-QoL); sociodemographic and disease-related information. After PR, a subsample of the patients took part in semi-structured interviews exploring their understanding of how they managed COPD-related anxiety during PR. Pre- and post-assessment of COPD-related anxiety and other PR outcomes were analysed with t-tests and correlation analyses. Qualitative interviews were analysed using a thematic analysis approach.

Results: A total of 72 patients with COPD (mean ± SD age 71 ± 8, 53% female) were included in the study, and 13 took part in qualitative interviews. A significant decrease in COPD-related anxiety was observed from before to after PR, corresponding to a small effect size (Cohen's d = 0.32; p = 0.018). Reductions in COPD-related anxiety were not associated with improvements in COPD-related disability, HR-QOL, or functional exercise capacity. The qualitative findings identified four anxiety management strategies, i.e., "planning", "problem-solving", "accepting", and "confronting", which were influenced by interactions with healthcare professionals and co-patients as well as patients' own perception.

Conclusions: COPD-related anxiety symptoms was reduced after PR, potentially through the use of various management strategies. The strategies appeared to be influenced by interactional factors during the PR program.

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