Self-management and quality of life in chronic obstructive pulmonary disease (COPD): The mediating effects of positive affect.
Self-management and quality of life in chronic obstructive pulmonary disease (COPD): The mediating effects of positive affect.
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DOI：
10.1016/j.pec.2015.10.031
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发表时间：
2016-04
影响因子：
3.5
通讯作者：
Dulohery MM
中科院分区：
文献类型：
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作者：
Benzo RP;Abascal-Bolado B;Dulohery MM
本研究旨在通过确定一般自我管理（SM）是否可以预测疾病特异性生活质量（QoL），通过调查特定SM领域是否在COPD中具有显著性，并通过探索SM和QoL之间的正/负影响的中介作用，来增加我们对COPD患者一般自我管理（SM）能力的理解。基于292例COPD患者的横断面研究。测量指标包括人口统计学、肺功能、步态速度、医疗保健利用、积极/消极影响、SM能力、呼吸困难和疾病特异性QoL。我们进行了相关性，多元回归模型和中介分析（积极/消极的影响之间的调解SM和生活质量协会）。在控制了呼吸困难、独居、婚姻状况、住院史、年龄和肺功能后，SM与生活质量相关（p< 0.0001）。行为投资（爱好和社会关系）和自我效能是与COPD患者生活质量独立相关的SM领域。由积极/消极情感比率测量的积极性完全介导SM与QoL的关系。调整显著性协变量后，SM与COPD患者疾病特异性QoL独立相关，但正/负情感比完全介导SM与QoL的关系。测量积极/消极的影响和解决投资行为和自我效能是重要的，在实施COPD-SM计划。
This study aimed to increase our understanding of general self-management (SM) abilities in COPD by determining if SM can predict disease specific quality of life (QoL), by investigating whether specific SM domains are significant in COPD and by exploring the mediating effect of the positive/negative affect in the association between SM and QoL. Cross-sectional study based on 292 patients with COPD. Measures included demographics, lung function, gait speed, health care utilization, positive/negative affect, SM abilities, breathlessness and disease specific QoL. We performed, correlation, multiple regression models and mediation analysis (positive/negative affect being mediator between SM and QoL association). After controlling for breathlessness, living alone, marital status, hospitalization history, age and lung function, SM related to QoL (p< 0.0001). Investment in behaviors (hobbies and social relationships) and self-efficacy are SM domains independently related to QoL in COPD. Positivity measured by the positive/negative affect ratio completely mediates the relationship of SM with QoL. SM is independently associated with disease specific QoL in COPD after adjustment significant covariates but positive/negative affect ratio completely mediates the relationship of SM with QoL. Measuring positive/negative affect and addressing investment behavior and self-efficacy are important in implementing COPD-SM programs.