中文版老年人体力活动量表在老年COPD患者中的应用及体力活动的影响因素分析
发布时间：2018-10-18 12:31
【摘要】：目的1.将中文版老年人体力活动量表(PASE)引入到老年慢性阻塞性肺疾病患者中;2.调查老年慢性阻塞性肺疾病患者体力活动的水平,并探索体力活动的影响因素。方法选取2015年3月至2016年5月在天津市第一中心医院门诊接受治疗的194例老年慢性阻塞性肺疾病患者作为研究对象。收集患者的一般资料;运用中文版老年人体力活动量表和国际体力活动问卷评估老年慢性阻塞性肺疾病患者的体力活动状况,运用SF-36生活质量量表评估患者的生活质量,运用慢性病自我效能量表评价患者的自我效能,运用计步器测量患者的步数,运用DOSE指数评价患者的疾病严重程度。检验中文版老年人体力活动量表的心理学特征,包括测量信度、效度和测量误差。信度的评定包括重测信度评定和内部一致性信度评定。效度的评定包括内容效度评定、同时效度评定、效标关联效度评定和结构效度评定。测量误差由测量的标准误差、最小可测变化值及一致性界限范围评价。采用便利抽样的方法,研究对象选取了2016年5月至2016年10月在天津市第一中心医院和天津市胸科医院门诊接受治疗的慢性阻塞性肺疾病患者209例。收集患者的一般资料,运用中文版老年人体力活动量表、SF-36生活质量量表、慢性病自我效能量表、医院焦虑抑郁量表和多维度疲劳量表等评定患者的相关状况。采用单因素分析检验不同分类变量中的体力活动水平的差异,采用相关性分析检验各连续变量与体力活动水平的相关性;采用多元线性逐步回归分析,进一步探讨老年慢性阻塞性肺疾病患者体力活动水平的影响因素。结果1.中文版老年人体力活动量表的信效度检验194例老年慢性阻塞性肺疾病患者参与研究,中文版PASE量表的Cronbach’sα系数为0.725;总体重测信度为0.980;条目水平的内容效度指数为0.70~1.00,全体一致量表水平的内容效度指数为0.70,平均量表水平的内容效度指数为0.93;校标关联效度为0.578;同时效度为0.698;PASE量表与SF-36和SES6的相关系数分别为0.522和0.600,与mMRC评分和DOSE指数的相关系数分别为-0.444和-0.405。测量的标准误差为6.96,最小可测变化值为19.29。2.老年慢性阻塞性肺疾病患者的体力活动水平及影响因素分析209例老年慢性阻塞性肺疾病患者参与了研究,体力活动水平得分为(71.29±51.44)分,低于正常老年人体力活动水平。单因素分析结果显示,社会人口学变量中,在职状况、氧疗状况、mMRC评分、GOLD分级、是否患有哮喘、是否患有冠心病的患者的体力活动水平的差异有统计学意义(P0.05);连续性变量中,生理机能、生理职能、情感职能、精力、社会功能、精神健康、一般健康状况、SES6、抑郁、握力、起坐试验与体力活动水平存在正相关(P0.05),年龄、吸烟、DOSE指数、焦虑、多维度疲劳量表MFI-20的五个维度(综合性疲劳、体力疲劳、活动减少、动机下降、脑力疲劳)与体力活动水平存在负相关(P0.05)。多元线性逐步回归分析结果显示:起坐试验、活动减少、SES6、在职状况和哮喘对体力活动水平有影响,五个变量对应的标准化偏回归系数分别为0.448、-0.243、0.239、-0.133、0.122,可解释体力活动总变异的62.5%,结论中文版老年人体力活动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,可以作为国内老年慢性阻塞性肺疾病患者体力活动水平的测量工具。老年慢性阻塞性肺疾病患者体力活动水平相对较低,有待进一步提高,其中下肢肌力、疲劳、自我效能、在职状况是影响患者体力活动水平的主要因素。故在今后的临床工作中,应加强对于患者体力活动水平的关注,积极改善影响体力活动水平的危险因素,采取针对性的干预措施,改善患者的体力活动现状,进而提高患者的生活质量。
[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.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.5
本文编号：2279129
[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.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.5
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