The status and correlation between disease uncertainty and alexithymia in elderly patients with chronic obstructive pulmonary disease_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

ZHANG Wen ¹ , LIU Linfeng ¹ , WANG Hongyan ¹ , LIANG Xiaoli ¹ , CAO Jun ¹ , ZHANG Yunqiu ² , LIU Yunqi ² ,  ZHANG Xiangeng ¹

1. Department of Discipline Research, Sichuan Nursing Vocational College, Chengdu, Sichuan 610100, P. R. China;
2. School of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610075, P. R. China;

Corresponding?author：

ZHANG Xiangeng, Email: xiangeng_99@163.com

Keywords：

Elderly; chronic obstructive pulmonary disease; disease uncertainty; alexithymia; correlation

DOI：

10.7507/1671-6205.202305014

Video：

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Objective To investigate the current status of disease uncertainty and alexithymia in elderly hospitalized patients with chronic obstructive pulmonary disease (COPD). Methods By using the convenience sampling method, a total of 165 elderly patients with COPD were investigated by using general information questionnaire, Mishel's uncertainty in illness Scale (MUIS) and Toronto alexithymia scale (TAS-20). Results The disease course of the elderly hospitalized patients with COPD was mostly 3 - 6 years (40.0%), and most of them had 1 - 2 chronic diseases (59.4%). More than half of the elderly had a history of smoking and drinking. The severity of COPD in the elderly was moderate (57.0%), and the number of hospitalization in the year was more than 2 times (58.8%). The score of disease uncertainty in the elderly hospitalized patients with COPD was 89.49±9.45, and the score of uncertainty was the highest (36.59±4.08), followed by the lack of information (18.51±1.86). The score of alexithymia in the elderly hospitalized patients with COPD was 55.32±6.37, and the score of all dimensions was the highest (21.87±2.93), followed by affective recognition disorder (18.27±2.55). The results of correlation analysis showed that the total score and scores of each dimension were positively correlated (P<0.01). The results of multi-factor analysis showed that age and course of disease and severity of COPD were the main influencing factors of disease uncertainty in elderly hospitalized patients with COPD (P<0.05). Conclusions The elderly hospitalized patients with COPD have a moderate level of disease uncertainty and a high degree of alexithymia. Besides, the greater the disease uncertainty is, the more serious the alexithymia. Therefore, clinical doctors and nurses should pay more attention to give emotional and psychological support and education guidance to the elderly patients with COPD, in order to improve their clinical efficacy and quality of life.

Citation： ZHANG Wen, LIU Linfeng, WANG Hongyan, LIANG Xiaoli, CAO Jun, ZHANG Yunqiu, LIU Yunqi, ZHANG Xiangeng. The status and correlation between disease uncertainty and alexithymia in elderly patients with chronic obstructive pulmonary disease. Chinese Journal of Respiratory and Critical Care Medicine, 2023, 22(7): 464-469. doi: 10.7507/1671-6205.202305014 Copy

1.	Zhu BF, Wang YF, Ming J, et al. Disease burden of COPD in China: a systematic review. Int J Chron Obstruct Pulmon Dis, 2018, 13: 1353-1364.
2.	Zha ZQ, Leng RX, Xu W, et al. Prevalence and risk factors of chronic obstructive pulmonary disease in Anhui Province, China: a population-based survey. BMC Pulm Med, 2019, 19(1): 102.
3.	闞亞楠. 慢性阻塞性肺疾病患者就醫行為現狀及其影響因素分析. 江蘇: 蘇州大學, 2020.
4.	陳靜娜, 陸關珍, 楊艷玲. 國內疾病不確定感研究熱點的共詞聚類分析. 護理管理雜志, 2021, 21(5): 365-369.
5.	Zhang YZ. Uncertainty in illness: theory review, application, and extension. Oncol Nurs Forum, 2017, 44(6): 645-649.
6.	Baudino MN, Gamwell KL, Roberts CM, et al. Disease severity and depressive symptoms in adolescents with inflammatory bowel disease: the mediating role of parent and youth illness uncertainty. J Pediatr Psychol, 2019, 44(4): 490-498.
7.	Delis PC. Uncertainty and quality of life in systemic lupus erythematosus: a cross-sectional study. Rehabil Nurs, 2019, 44(1): 2-10.
8.	公淼, 刁惠民, 胡敏. 慢性阻塞性肺疾病患者疾病不確定感與應對方式的相關性分析. 解放軍護理雜志, 2017, 34(9): 47-50.
9.	董錦錦, 張建華, 郜珍妮, 等. 述情障礙的研究進展. 精神醫學雜志, 2021, 34(6): 565-569.
10.	張盼, 左曉偉, 陳碧, 等. 述情障礙在慢性阻塞性肺疾病中的流行及影響因素分析. 現代預防醫學, 2022, 49(9): 1659-1663.
11.	熊智, 董浩, 任祥春. 述情障礙在慢性阻塞性肺疾病患者病情評估中的臨床意義. 中國呼吸與危重監護雜志, 2015, 14(1): 10-12.
12.	王鳳燕, 張冬瑩, 梁振宇, 等. 面向全科醫生的《慢性阻塞性肺疾病診治指南(2021年修訂版)》解讀. 中國全科醫學, 2021, 24(29): 3660-3663, 3677.
13.	Mishel MH. The measurement of uncertainty in illness. Nurs Res, 1981, 30(5): 258-263.
14.	徐淑蓮, 黃秀梨. Mishel疾病不確定感量表之中文版測試. 護理研究, 1985, 4(1A): 59-69.
15.	Bagby RM, Taylor GJ, Parker JD. The Twenty-item Toronto Alexithymia Scale--II. Convergent, discriminant, and concurrent validity. J Psychosom Res, 1994, 38(1): 33-40.
16.	蟻金瑤, 姚樹橋, 朱熊兆. TAS-20中文版的信度、效度分析. 中國心理衛生雜志, 2003, 17(11): 763-767.
17.	孫曉嵐, 趙慧敏, 劉楊禾, 等. COPD病人疾病不確定感與疾病認知水平的相關性研究. 全科護理, 2021, 19(17): 2433-2436.
18.	Kurita K, Garon EB, Stanton AL, et al. Uncertainty and psychological adjustment in patients with lung cancer. Psychooncology, 2013, 22(6): 1396-1401.
19.	趙慧敏, 李節, 毛靖. COPD病人疾病不確定感與應對方式的相關性研究. 全科護理, 2019, 17(9): 1025-1028.
20.	趙慧敏, 毛靖, 李育玲, 等. 慢性阻塞性肺疾病患者家屬疾病不確定感與社會支持相關性研究. 齊魯護理雜志, 2018, 24(15): 1-4.
21.	張颯. 老年慢性阻塞性肺疾病患者疾病不確定感、社會支持與健康行為的相關性研究. 河南大學, 2021.
22.	Mullins AJ, Gamwell KL, Sharkey CM, et al. Illness uncertainty and illness intrusiveness as predictors of depressive and anxious symptomology in college students with chronic illnesses. J Am Coll Health, 2017, 65(5): 352-360.
23.	宋喜珍. 慢性阻塞性肺疾病患者疾病不確定感與焦慮、抑郁情緒的相關性. 現代臨床護理, 2012, 11(11): 16-18.
24.	Han D, Zhang YQ, Li B, et al. Alexithymia in Chinese chronic obstructive pulmonary disease (COPD) patients: the prevalence and related factors of alexithymia. Psychiatry Res, 2012, 198(2): 274-278.
25.	Snène H, Rafrafi R, Salah N, et al. Anxiety and depression in Tunisian patients with COPD. Tunis Med, 2021, 99(6): 623-631.
26.	徐鳳麟, 孫建萍. 老年慢性病患者述情障礙的研究進展. 中華護理雜志, 2018, 53(1): 105-109.
27.	李艷玲, 張春舫, 高莉梅, 等. 慢性阻塞性肺疾病患者述情障礙及其相關因素分析. 廣東醫學, 2012, 33(22): 3474-3477.
28.	吳海麗. 社區老年慢性病患者疾病不確定感與述情障礙的相關性研究. 中國社區醫師, 2020, 36(30): 132-133.
29.	徐鳳麟, 吳紅霞, 孫建萍, 等. 養老機構老年慢性病患者疾病不確定感與述情障礙的相關性研究. 中華現代護理雜志, 2018, 24(19): 2281-2283.
30.	Hoth KF, Wamboldt FS, Ford DW, et al. The social environment and illness uncertainty in chronic obstructive pulmonary disease. Int J Behav Med, 2015, 22(2): 223-232.
31.	侯曉美. COPD患者自我護理能力與不確定感及應對方式的關系研究. 西南國防醫藥, 2015, 25(2): 188-190.

1. Zhu BF, Wang YF, Ming J, et al. Disease burden of COPD in China: a systematic review. Int J Chron Obstruct Pulmon Dis, 2018, 13: 1353-1364.
2. Zha ZQ, Leng RX, Xu W, et al. Prevalence and risk factors of chronic obstructive pulmonary disease in Anhui Province, China: a population-based survey. BMC Pulm Med, 2019, 19(1): 102.
3. 闞亞楠. 慢性阻塞性肺疾病患者就醫行為現狀及其影響因素分析. 江蘇: 蘇州大學, 2020.
4. 陳靜娜, 陸關珍, 楊艷玲. 國內疾病不確定感研究熱點的共詞聚類分析. 護理管理雜志, 2021, 21(5): 365-369.
5. Zhang YZ. Uncertainty in illness: theory review, application, and extension. Oncol Nurs Forum, 2017, 44(6): 645-649.
6. Baudino MN, Gamwell KL, Roberts CM, et al. Disease severity and depressive symptoms in adolescents with inflammatory bowel disease: the mediating role of parent and youth illness uncertainty. J Pediatr Psychol, 2019, 44(4): 490-498.
7. Delis PC. Uncertainty and quality of life in systemic lupus erythematosus: a cross-sectional study. Rehabil Nurs, 2019, 44(1): 2-10.
8. 公淼, 刁惠民, 胡敏. 慢性阻塞性肺疾病患者疾病不確定感與應對方式的相關性分析. 解放軍護理雜志, 2017, 34(9): 47-50.
9. 董錦錦, 張建華, 郜珍妮, 等. 述情障礙的研究進展. 精神醫學雜志, 2021, 34(6): 565-569.
10. 張盼, 左曉偉, 陳碧, 等. 述情障礙在慢性阻塞性肺疾病中的流行及影響因素分析. 現代預防醫學, 2022, 49(9): 1659-1663.
11. 熊智, 董浩, 任祥春. 述情障礙在慢性阻塞性肺疾病患者病情評估中的臨床意義. 中國呼吸與危重監護雜志, 2015, 14(1): 10-12.
12. 王鳳燕, 張冬瑩, 梁振宇, 等. 面向全科醫生的《慢性阻塞性肺疾病診治指南(2021年修訂版)》解讀. 中國全科醫學, 2021, 24(29): 3660-3663, 3677.
13. Mishel MH. The measurement of uncertainty in illness. Nurs Res, 1981, 30(5): 258-263.
14. 徐淑蓮, 黃秀梨. Mishel疾病不確定感量表之中文版測試. 護理研究, 1985, 4(1A): 59-69.
15. Bagby RM, Taylor GJ, Parker JD. The Twenty-item Toronto Alexithymia Scale--II. Convergent, discriminant, and concurrent validity. J Psychosom Res, 1994, 38(1): 33-40.
16. 蟻金瑤, 姚樹橋, 朱熊兆. TAS-20中文版的信度、效度分析. 中國心理衛生雜志, 2003, 17(11): 763-767.
17. 孫曉嵐, 趙慧敏, 劉楊禾, 等. COPD病人疾病不確定感與疾病認知水平的相關性研究. 全科護理, 2021, 19(17): 2433-2436.
18. Kurita K, Garon EB, Stanton AL, et al. Uncertainty and psychological adjustment in patients with lung cancer. Psychooncology, 2013, 22(6): 1396-1401.
19. 趙慧敏, 李節, 毛靖. COPD病人疾病不確定感與應對方式的相關性研究. 全科護理, 2019, 17(9): 1025-1028.
20. 趙慧敏, 毛靖, 李育玲, 等. 慢性阻塞性肺疾病患者家屬疾病不確定感與社會支持相關性研究. 齊魯護理雜志, 2018, 24(15): 1-4.
21. 張颯. 老年慢性阻塞性肺疾病患者疾病不確定感、社會支持與健康行為的相關性研究. 河南大學, 2021.
22. Mullins AJ, Gamwell KL, Sharkey CM, et al. Illness uncertainty and illness intrusiveness as predictors of depressive and anxious symptomology in college students with chronic illnesses. J Am Coll Health, 2017, 65(5): 352-360.
23. 宋喜珍. 慢性阻塞性肺疾病患者疾病不確定感與焦慮、抑郁情緒的相關性. 現代臨床護理, 2012, 11(11): 16-18.
24. Han D, Zhang YQ, Li B, et al. Alexithymia in Chinese chronic obstructive pulmonary disease (COPD) patients: the prevalence and related factors of alexithymia. Psychiatry Res, 2012, 198(2): 274-278.
25. Snène H, Rafrafi R, Salah N, et al. Anxiety and depression in Tunisian patients with COPD. Tunis Med, 2021, 99(6): 623-631.
26. 徐鳳麟, 孫建萍. 老年慢性病患者述情障礙的研究進展. 中華護理雜志, 2018, 53(1): 105-109.
27. 李艷玲, 張春舫, 高莉梅, 等. 慢性阻塞性肺疾病患者述情障礙及其相關因素分析. 廣東醫學, 2012, 33(22): 3474-3477.
28. 吳海麗. 社區老年慢性病患者疾病不確定感與述情障礙的相關性研究. 中國社區醫師, 2020, 36(30): 132-133.
29. 徐鳳麟, 吳紅霞, 孫建萍, 等. 養老機構老年慢性病患者疾病不確定感與述情障礙的相關性研究. 中華現代護理雜志, 2018, 24(19): 2281-2283.
30. Hoth KF, Wamboldt FS, Ford DW, et al. The social environment and illness uncertainty in chronic obstructive pulmonary disease. Int J Behav Med, 2015, 22(2): 223-232.
31. 侯曉美. COPD患者自我護理能力與不確定感及應對方式的關系研究. 西南國防醫藥, 2015, 25(2): 188-190.

Chinese Journal of Respiratory and Critical Care Medicine

The status and correlation between disease uncertainty and alexithymia in elderly patients with chronic obstructive pulmonary disease

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