만성폐쇄성폐질환자의 우울, 사회적 지지, 불확실성이 자가관리이행에 미치는 영향

Abstract

Purpose

This study aims to identify depression, social support, uncertainty, and self- management compliance in patients with chronic obstructive pulmonary disease, and to identify the influencing factors to enhance self-management compliance in these patients.

Method

This study employed a descriptive survey research design. The participants consisted of 160 patients diagnosed with chronic obstructive pulmonary disease(COPD). They were recruited from the respiratory ward of a university hospital located in Metropolitan City B. Data collection took place from August 22, 2023, to September 27, 2023. Data analysis was performed using SPSS/WIN 29.0 software. General and disease-related characteristics of the participants were examined using frequency, percentage, mean, and standard deviation. Depression, social support, uncertainty and the level of self-management compliance were analyzed using mean and standard deviation. Independent samples t-tests and one-factor ANOVA were used for the differences in self-management compliance based on general and disease-related characteristics, followed by post-hoc Scheffé tests. The relationships between these variables were assessed using Pearson correlation coefficients, and factors influencing self-management compliance were identified through hierarchical multiple regression analysis.

Result

Patients diagnosed with COPD exhibited statistically significant differences in self-management compliance based on their general and disease-related characteristics, specifically in relation to gender (t=-3.53, p<.001), living with family (t=-3.99, p<.001), economic status (t=7.01, p<.001), and current smoking status (t=2.32, p=.022). Self-management compliance was positively correlated with social support (r=0.53, p<.001) and negatively correlated with depression (r=-0.64, p<.001) and uncertainty (r=-0.65, p<.001), all of which were statistically significant. Uncertainty (β=-0.34, p<.001), depression (β=-0.33, p<.001), social support (β=0.18, p=.005), and current smoking status (β=0.14, p=.008) were considered as factors influencing the self-management compliance of patients diagnosed with COPD, and with uncertainty having the maximum influence among them. These influencing factors explained 61.0% of the total variation of outcomes regarding the self-management compliance of patients diagnosed with COPD.

Conclusion

Considering on the current research findings, it has been observed that self-management compliance increases as uncertainty and depression decrease. Furthermore this results indicate that higher levels of social support and current non-smoking behavior are associated with increased self-management compliance. Thus it is anticipated that developing strategies to address uncertainty and depression positively, enhancing social support, and supporting smoking cessation could effectively promote self-management compliance in patients with COPD.