老年慢性阻塞性肺疾病患者激活水平的潜在类别、影响因素及护理对策 [中文引用][英文引用]

目的  探索老年慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）患者激活水平的潜在剖面分类及其影响因素，并总结护理对策。方法  采用便利抽样法，2025 年 1 月— 7 月选取乌鲁木齐市某三级甲等综合医院呼吸科的 349 例老年 COPD 患者为研究对象，采用患者激活水平测量量表（patient activation measure，PAM）、无法忍受不确定性量表（intolerance of uncertainty scale-12，IUS-12）、COPD 患者健康素养量表（COPD knowledge questionnaire，COPD-Q）和领悟社会支持量表（perceived social support scale，PSSS）进行调查。采用潜在剖面分析识别老年 COPD 患者激活水平的潜在类别，采用多元Logistic回归进一步分析其相关影响因素。结果  349例老年 COPD患者完成研究。老年 COPD患者激活水平得分为（56.7±15.7）分，总体处于中等水平，可分为 3 个潜在类别：动力薄弱型（41.3%）、认知先导 - 行动滞后型（45.0%）和自主驱动型（13.7%）。Logistic 回归分析结果显示，规律锻炼、无法忍受不确定性、健康素养和社会支持是老年 COPD 患者激活水平不同类别的影响因素（均 P<0.05）。结论  老年 COPD 患者激活水平具有明显的分类特征，医护人员可根据不同类别患者的特点及其影响因素实施针对性干预，以提高患者激活水平，助力患者健康行为。

Objective To determine the latent profiles of activation in elderly patients with chronic obstructive pulmonary disease（COPD）and the factors influencing on activation. Methods Convenience sampling was applied to recruit 349 elderly COPD patients from the Department of Respiratory Diseases of a Tier-IIIA hospital in Urumqi for a cross-sectional study. Data were collected through the patient activation measurement scale，intolerance of uncertainty scale-12，COPD knowledge questionnaire，and perceived social support scale. Latent profile analysis was used to identify the latent profiles of activation，and multivariate Logistic regression was used to determine the influencing factors. Results All 349 elderly COPD patients completed the study. The average score of activation was 56.7 ± 15.7，at a moderate level. Three latent profiles were identified，including weak motivation（41.3%），cognitive lead-action lag （45.0%）and autonomic motivation（13.7%）. Logistic regression analysis showed that regular exercise，intolerance of uncertainty，health literacy and social support were the factors influencing the activation（all P<0.05）. Conclusion Activation of elderly COPD patients has obvious categorical characteristics. Targeted interventions should be carried out according to the characteristics of different category to improve the activation of the patients，thereby enhancing their healthy motivation.