新疆医科大学学报

目的 探讨慢性阻塞性肺疾病(COPD)住院患者的自我管理现状及其影响因素，为制定个体化的自我管理干预策略提供依据。方法 采用完全随机整群抽样法，选取2024年1-6月在新疆两所三甲医院呼吸内科住院的COPD患者为研究对象。采用一般资料调查表及COPD患者自我管理量表进行问卷调查，收集患者的人口学特征和疾病相关临床资料。采用单因素和多因素分析探讨COPD患者自我管理能力的影响因素。结果 共纳入663例COPD住院患者，自我管理平均得分为(156.84±37.90)分，患者自我管理能力为中等水平(124～180)分。单因素结果显示，年龄、婚姻状况、职业、居住地、家庭人口数、家庭月均收入、吸烟情况、是否经常接触二手烟、是否经常在家做饭、做饭使用燃料的种类、冬季取暖方式及燃料、工作是否接触粉尘、工作是否接触有害气体、COPD确诊时间、COPD分级、修订版医学研究委员会呼吸困难量表(mMRC)分级、是否接种过流感疫苗、慢性疾病数量、此次住院天数、最近一年总住院天数和最近一年住院次数与患者自我管理能力相关(P均<0.05)。多元Logistic回归分析结果显示，以高等水平为参照组，自我管理水平低的患者独立影响因素包括：职业为商业、服务业或未就业、经常接触二手烟、经常在家做饭、最近一年总住院天数15～<31 d;自我管理水平中等的患者独立影响因素包括：年龄0～<50岁、职业为商业、服务业、家庭月均收入3 000～<10 000元、经常接触二手烟、经常在家做饭、COPD分级为重度、mMRC分级为0或1级、最近一年总住院天数为8～<15 d或15～<31 d(P均<0.05)。结论 COPD住院患者的自我管理能力总体处于中等水平，且受到年龄、职业、是否经常接受二手烟、是否经常做饭、COPD分级、mMRC分级和最近一年总住院天数等因素的影响，需制定个性化的健康教育计划，并通过定期随访提升患者的自我管理能力，从而改善病情和生活质量。

Objective To explore the current status of self-management and its influencing factors in hospitalized patients with chronic obstructive pulmonary disease(COPD), and to provide a basis for the development of individualized self-management intervention strategies. Methods A completely random cluster sampling method was used to select COPD patients hospitalized in the hospitals in Xinjiang from January to June 2024. A general information questionnaire and the COPD Self-Management Scale were used to conduct a survey, collecting patients′ demographic characteristics and disease-related clinical data. Univariate and multivariate analyses were conducted to explore the factors influencing the self-management ability of COPD patients. Results A total of 663 hospitalized COPD patients were included in the study. The average self-management score was(156.84±37.90), with self-management ability being at a moderate level(124-180). Univariate analysis showed that age, marital status, occupation, residence, family size, average monthly family income, smoking status, exposure to second-hand smoke, frequent cooking at home, types of cooking fuel used, winter heating method and fuel, exposure to dust at work, exposure to harmful gases at work, time since COPD diagnosis, COPD classification, mMRC classification, flu vaccination status, number of chronic diseases, length of hospitalization this time, total hospitalization days in the past year and the number of hospitalizations in the past year were found to be significantly associated with self-management ability(P<0.05). Multivariate Logistic regression analysis revealed that, with high self-management level as the reference group, independent factors influencing low self-management included: the occupation is business, service or not employed, frequent exposure to second-hand smoke, frequent cooking at home and total hospitalization days in the past year being 15-<31 days. Independent factors influencing moderate self-management included: age between 0-<50 years, occupation was business, service industry, monthly family income of 3 000-<10 000, frequent exposure to second-hand smoke, frequent cooking at home, severe COPD classification, mMRC classification of 0 or 1 and total hospitalization days in the past year being 8-<15 or 15-<31 days(P<0.05). Conclusion The self-management ability of COPD hospitalizedpatients is generally at a moderate level and is influenced by factors such as age, occupation, frequent exposure to second-hand smoke, frequent cooking, COPD classification, mMRC classification and total hospitalization days in the past year. Personalized health education plans need to be developed, and regular follow-ups should be conducted to enhance patients′self-management abilities, thereby improving disease control and quality of life.