A qualitative research on fatigue cognition and coping experience in elderly patients with chronic obstructive pulmonary disease

Zhenxia Zhang, Hongyan Shao
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Abstract

Objective To investigate the cognition and coping experience of fatigue in elderly patients with chronic obstructive pulmonary disease (COPD), so as to provide basis and research basis for the preparation of fatigue intervention measures for elderly patients with COPD. Methods Qualitative research interview was used to conduct face-to-face and in-depth communication with 12 elderly patients with COPD under the guidance of pre-prepared interview outline. The 7-step Colaizzi analysis method was used to analyze the transcript of the interview and extract the theme and representative statements. Results Fatigue cognition could be summarized into five themes:fatigue symptoms were often accompanied by drowsiness, fatigue, anxiety, poor sleep, memory loss and other symptoms; there was no definite time point for the appearance of fatigue symptoms; breathing difficulties, limited activities, mental and psychological disorders and deficient social support were the main causes of fatigue; family accidents, seasonal variation, the occurrence of complications and relapses of the malady were the aggravating factors of fatigue symptoms; fatigue affects the patient′s ability to move, social circle and life motivation. Coping experiences could be summarized into three themes: strengthen self-management and ask for help; take the initiative to learn and improve the level of self-care; emotional disorder, negative response. Conclusions There are obvious fatigue symptoms in elderly patients with COPD. Affected by many factors, such as disease factors, self-perceived burden level, family support and social support level, most patients have insufficient fatigue cognition and lack of coping ability. Medical staff should fully understand the fatigue cognition and coping experience of such patients and implement effective intervention programs to improve the coping ability of patients. Key words: Aged; Pulmonary disease, chronic obstructive; Fatigue cognition; Coping experience; Qualitative research
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老年慢性阻塞性肺疾病患者疲劳认知及应对经验的定性研究
目的了解老年慢性阻塞性肺疾病(COPD)患者对疲劳的认知和应对经验,为老年COPD患者疲劳干预措施的制定提供依据和研究依据。方法采用质性研究访谈法,在事先编写的访谈提纲指导下,对12例老年COPD患者进行面对面深入交流。采用Colaizzi七步分析法对访谈笔录进行分析,提取访谈主题和代表性陈述。结果疲劳认知可归纳为五大主题:疲劳症状常伴有嗜睡、疲劳、焦虑、睡眠差、记忆力减退等症状;疲劳症状的出现没有明确的时间点;呼吸困难、活动受限、精神和心理障碍以及缺乏社会支持是疲劳的主要原因;家庭意外事故、季节变化、并发症的发生和疾病的复发是疲劳症状的加重因素;疲劳会影响患者的活动能力、社交圈和生活动机。应对经验可以归纳为三个主题:加强自我管理,寻求帮助;主动学习,提高自理水平;情绪障碍,消极反应。结论老年COPD患者存在明显的疲劳症状。受疾病因素、自我感知负担水平、家庭支持和社会支持水平等多种因素的影响,大多数患者存在疲劳认知不足和应对能力不足。医务人员应充分了解该类患者的疲劳认知和应对经验,实施有效的干预方案,提高患者的应对能力。关键词:老年;慢性阻塞性肺病;疲劳认知;应对经验;定性研究
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