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.	阚亚楠. 慢性阻塞性肺疾病患者就医行为现状及其影响因素分析. 江苏: 苏州大学, 2020.
4.	陈静娜, 陆关珍, 杨艳玲. 国内疾病不确定感研究热点的共词聚类分析. 护理管理杂志, 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确定感与应对方式的相关性分析. 解放军护理杂志, 2017, 34(9): 47-50.
9.	董锦锦, 张建华, 郜珍妮, 等. 述情障碍的研究进展. 精神医学杂志, 2021, 34(6): 565-569.
10.	张盼, 左晓伟, 陈碧, 等. 述情障碍在慢性阻塞性肺疾病中的流行及影响因素分析. 现代预防医学, 2022, 49(9): 1659-1663.
11.	熊智, 董浩, 任祥春. 述情障碍在慢性阻塞性肺疾病患者病情评估中的临床意义. 中国呼吸与危重监护杂志, 2015, 14(1): 10-12.
12.	王凤燕, 张冬莹, 梁振宇, 等. 面向全科医生的《慢性阻塞性肺疾病诊治指南(2021年修订版)》解读. 中国全科医学, 2021, 24(29): 3660-3663, 3677.
13.	Mishel MH. The measurement of uncertainty in illness. Nurs Res, 1981, 30(5): 258-263.
14.	徐淑莲, 黄秀梨. Mishel疾病不确定感量表之中文版测试. 护理研究, 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.	蚁金瑶, 姚树桥, 朱熊兆. TAS-20中文版的信度、效度分析. 中国心理卫生杂志, 2003, 17(11): 763-767.
17.	孙晓岚, 赵慧敏, 刘杨禾, 等. COPD病人疾病不确定感与疾病认知水平的相关性研究. 全科护理, 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.	赵慧敏, 李节, 毛靖. COPD病人疾病不确定感与应对方式的相关性研究. 全科护理, 2019, 17(9): 1025-1028.
20.	赵慧敏, 毛靖, 李育玲, 等. 慢性阻塞性肺疾病患者家属疾病不确定感与社会支持相关性研究. 齐鲁护理杂志, 2018, 24(15): 1-4.
21.	张飒. 老年慢性阻塞性肺疾病患者疾病不确定感、社会支持与健康行为的相关性研究. 河南大学, 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确定感与焦虑、抑郁情绪的相关性. 现代临床护理, 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.	徐凤麟, 孙建萍. 老年慢性病患者述情障碍的研究进展. 中华护理杂志, 2018, 53(1): 105-109.
27.	李艳玲, 张春舫, 高莉梅, 等. 慢性阻塞性肺疾病患者述情障碍及其相关因素分析. 广东医学, 2012, 33(22): 3474-3477.
28.	吴海丽. 社区老年慢性病患者疾病不确定感与述情障碍的相关性研究. 中国社区医师, 2020, 36(30): 132-133.
29.	徐凤麟, 吴红霞, 孙建萍, 等. 养老机构老年慢性病患者疾病不确定感与述情障碍的相关性研究. 中华现代护理杂志, 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.	侯晓美. COPD患者自我护理能力与不确定感及应对方式的关系研究. 西南国防医药, 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. 阚亚楠. 慢性阻塞性肺疾病患者就医行为现状及其影响因素分析. 江苏: 苏州大学, 2020.
4. 陈静娜, 陆关珍, 杨艳玲. 国内疾病不确定感研究热点的共词聚类分析. 护理管理杂志, 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确定感与应对方式的相关性分析. 解放军护理杂志, 2017, 34(9): 47-50.
9. 董锦锦, 张建华, 郜珍妮, 等. 述情障碍的研究进展. 精神医学杂志, 2021, 34(6): 565-569.
10. 张盼, 左晓伟, 陈碧, 等. 述情障碍在慢性阻塞性肺疾病中的流行及影响因素分析. 现代预防医学, 2022, 49(9): 1659-1663.
11. 熊智, 董浩, 任祥春. 述情障碍在慢性阻塞性肺疾病患者病情评估中的临床意义. 中国呼吸与危重监护杂志, 2015, 14(1): 10-12.
12. 王凤燕, 张冬莹, 梁振宇, 等. 面向全科医生的《慢性阻塞性肺疾病诊治指南(2021年修订版)》解读. 中国全科医学, 2021, 24(29): 3660-3663, 3677.
13. Mishel MH. The measurement of uncertainty in illness. Nurs Res, 1981, 30(5): 258-263.
14. 徐淑莲, 黄秀梨. Mishel疾病不确定感量表之中文版测试. 护理研究, 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. 蚁金瑶, 姚树桥, 朱熊兆. TAS-20中文版的信度、效度分析. 中国心理卫生杂志, 2003, 17(11): 763-767.
17. 孙晓岚, 赵慧敏, 刘杨禾, 等. COPD病人疾病不确定感与疾病认知水平的相关性研究. 全科护理, 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. 赵慧敏, 李节, 毛靖. COPD病人疾病不确定感与应对方式的相关性研究. 全科护理, 2019, 17(9): 1025-1028.
20. 赵慧敏, 毛靖, 李育玲, 等. 慢性阻塞性肺疾病患者家属疾病不确定感与社会支持相关性研究. 齐鲁护理杂志, 2018, 24(15): 1-4.
21. 张飒. 老年慢性阻塞性肺疾病患者疾病不确定感、社会支持与健康行为的相关性研究. 河南大学, 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确定感与焦虑、抑郁情绪的相关性. 现代临床护理, 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. 徐凤麟, 孙建萍. 老年慢性病患者述情障碍的研究进展. 中华护理杂志, 2018, 53(1): 105-109.
27. 李艳玲, 张春舫, 高莉梅, 等. 慢性阻塞性肺疾病患者述情障碍及其相关因素分析. 广东医学, 2012, 33(22): 3474-3477.
28. 吴海丽. 社区老年慢性病患者疾病不确定感与述情障碍的相关性研究. 中国社区医师, 2020, 36(30): 132-133.
29. 徐凤麟, 吴红霞, 孙建萍, 等. 养老机构老年慢性病患者疾病不确定感与述情障碍的相关性研究. 中华现代护理杂志, 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. 侯晓美. COPD患者自我护理能力与不确定感及应对方式的关系研究. 西南国防医药, 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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