Domain-specific self-efficacy is associated with measures of functional capacity and quality of life among patients with moderate to severe chronic obstructive pulmonary disease.
Domain-specific self-efficacy is associated with measures of functional capacity and quality of life among patients with moderate to severe chronic obstructive pulmonary disease.
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DOI：
10.1513/annalsats.201308-273bc
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发表时间：
2014-03-01
影响因子：
8.3
通讯作者：
Bae, Sejong
中科院分区：
文献类型：
--
作者：
Jackson, Bradford E;Coultas, David B;Bae, Sejong
理论基础：自我效能感和健康行为之间的关系已经确立。然而，对慢性阻塞性肺疾病(COPD)患者的自我效能和健康相关指标之间的关系知之甚少。目的：这项横断面队列研究的目的是检验一组中重度COPD患者的COPD自我效能量表(CSE)总分和特定子域得分与功能能力和生活质量之间的关系。自我效能感的测量使用CSES的五个领域：负面情绪、情绪唤醒、体力消耗、天气/环境和行为。生活质量和功能能力的测量包括SF-12：身心综合评分、慢性呼吸问卷、呼吸困难领域和6分钟步行试验。统计分析包括Spearman相关性和使用调整潜在混杂因素的一般线性模型对自我效能感(“自信”与“不自信”)的分类分析。测量和主要结果：325名患者入选，平均年龄(标准差)为68.5(9.48)岁，其中49.5%为男性，91.69%为非西班牙裔白人。消极情绪、情绪唤醒和体力消耗领域与SF-12心理综合评分和慢性呼吸困难领域呈中度相关(范围为0.3~0.7)。在探索每个CSES领域的“自信”与“不自信”的模型中，并根据年龄、性别、种族、背包年限和气流障碍严重程度进行调整，在负面情绪、情绪唤醒和体力消耗领域与功能能力和生活质量之间存在多种临床和统计学上显著的关联。结论：CSES总分与更好的生活质量和功能能力相关。我们对亚域的分析表明，体力消耗、负面情绪和情绪唤醒亚域与功能能力和生活质量指标的相关性最大。这些发现表明，提高自我效能感的干预措施可能会改善中重度COPD患者的功能能力和生活质量。
RATIONALE: The relationship between self-efficacy and health behaviors is well established. However, little is known about the relationship between self-efficacy and health-related indicators among patients with chronic obstructive pulmonary disease (COPD).OBJECTIVES: The purpose of this cross-sectional cohort study was to test the hypothesis that the total score and specific subdomain scores of the COPD Self-Efficacy Scale (CSES) are associated with functional capacity and quality of life in a group of patients with moderate to severe COPD.METHODS: Relationships were examined in a cross-sectional study of baseline data collected as part of a randomized trial. Self-efficacy was measured using the five domains of the CSES: negative affect, emotional arousal, physical exertion, weather/environment, and behavioral. Measures of quality of life and functional capacity included SF-12: physical and mental composite scores, Chronic Respiratory Questionnaire dyspnea domain, and the 6-minute-walk test. Statistical analyses included Spearman correlation and categorical analyses of self-efficacy ("confident" vs. "not confident") using general linear models adjusting for potential confounders.MEASUREMENTS AND MAIN RESULTS: There were 325 patients enrolled with a mean age (standard deviation) of 68.5 (9.48) years, 49.5% male, and 91.69% non-Hispanic white. The negative affect, emotional arousal, and physical exertion domains were moderately correlated (range, 0.3-0.7) with the SF-12 mental composite score and Chronic Respiratory Questionnaire dyspnea domain. In models exploring each CSES domain as "confident" versus "not confident" and adjusting for age, sex, race, pack-years, and airflow obstruction severity, there were multiple clinically and statistically significant associations between the negative affect, emotional arousal, and physical exertion domains with functional capacity and quality of life.CONCLUSIONS: The aggregated total CSES score was associated with better quality of life and functional capacity. Our analysis of subdomains revealed that the physical exertion, negative affect, and emotional arousal subdomains had the largest associations with functional capacity and quality of life indicators. These findings suggest that interventions to enhance self-efficacy may improve the functional capacity and quality of life of patients with moderate to severe COPD.