|
|
|
| Mediating effect of activities of daily living among patients with chronic obstructive pulmonary disease on caregiver ability and caregiver burden |
| LIU Wei1, GAO Xing1, WANG Danxin2, ZHANG Ling1, WANG Shiyuan1, LI Huiyan2
|
1. School of Nursing, Hainan Medical University, Haikou, Hainan 571199, China;
2. The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan 570102, China |
|
|
|
|
Abstract Objective To analyze the mediating effect of activities of daily living (ADL) among patients with chronic obstructive pulmonary disease (COPD) on caregiver ability and caregiver burden, so as to provide a basis for improving the quality of care. Methods From February 2024 to March 2025, COPD patients and their caregivers from the Department of Pulmonary and Critical Care Medicine of a tertiary hospital in Haikou were selected using convenience sampling method. Data on the basic characteristics of both caregivers and patients were collected through questionnaire surveys. The Chinese version of the Family Caregiver Capacity Scale, the Chinese version of the Caregiver Burden Inventory, and the Barthel Index were used to assess caregiver ability, caregiver burden, and patients' ADL, respectively. The mediating effect of ADL among COPD patients on caregiver ability and caregiver burden was analyzed using the Process macro 4.0, with the significance tested via the Bootstrap method. Results A total of 348 caregivers were surveyed, among whom 274 (78.74%) were females and 74 (21.26%) were males. The majority of caregivers were aged 40 years and above, with 291 individuals (83.62%). The relationship between caregivers and patients was primarily that of being their children, with 185 individuals (53.16%). Correspondingly, 348 COPD patients were surveyed, and the predominant type of medical insurance was the New Rural Cooperative Medical Scheme, with 172 cases (49.43%). The median scores of caregiver ability, caregiver burden, and patients' ADL were 19.00 (interquartile range, 5.00), 47.00 (interquartile range, 8.00) and 45.00 (interquartile range, 15.00) points, respectively. Mediating analysis showed that caregiver ability directly affected caregiver burden, with an effect value of 0.693 (95%CI: 0.553-0.832). It also indirectly affected caregiver burden through the patients' ADL, with an effect value of 0.104 (95%CI: 0.029-0.179). This mediating effect accounted for 13.05% of the total effect. Conclusion The ADL of COPD patients played a mediating role between caregiver ability and caregiver burden, with caregiver ability exerting a significant positive indirect effect on caregiver burden through patients' ADL.
|
|
Received: 08 July 2025
Revised: 10 September 2025
Published: 20 November 2025
|
|
|
|
|
|
[1] 沈敏,郁智慧,朱爱韬.1992—2021年中国慢性阻塞性肺疾病发病和死亡的年龄-时期-队列分析[J].预防医学,2025,37(2):113-117.
SHEN M,YU Z H,ZHU A T.Age-period-cohort analysis of incidence and mortality of chronic obstructive pulmonary disease in China from 1992 to 2021[J].China Prev Med J,2025,37(2):113-117.(in Chinese)
[2] GBD 2021 Forecasting Collaborators.Burden of disease scenarios for 204 countries and territories,2022-2050:a forecasting analysis for the Global Burden of Disease Study 2021BD 2021 Forecasting Collaborators.Burden of disease scenarios for 204 countries and territories,2022-2050:a forecasting analysis for the Global Burden of Disease Study 2021[J].Lancet,2024,403(10440):2204-2256.
[3] YANG H J,YANG Y Q,WANG F Y,et al.Clinical and prognostic differences in mild to moderate COPD with and without emphysema[J].Chest,2025,167(3):724-735.
[4] CHERIAN M,MASOUDIAN P,THAVORN K,et al.The impact of frailty on clinical outcomes among individuals with COPD:a systematic review and meta-analysis[J].BMC Pulm Med,2025,25(1):1-12.
[5] ZHANG N,TIAN Z,LIU X Y,et al.Burden,coping and resilience among caregivers for patients with chronic obstructive pulmonary disease:an integrative review[J].J Clin Nurs,2024,33(4):1346-1361.
[6] JOHANSSON H,BERTERÖC,JONASSON L L,et al.The experience of caregiver burden when being next of kin to a person with severe chronic obstructive pulmonary disease:a qualitative study[J/OL].Chron Respir Dis,2023,20[2025-09-10].https://doi.org/10.1177/14799731231168897.
[7] 伊默,姜迪,贾元敏,等.照顾者负担在慢性阻塞性肺疾病患者自理能力和症状控制间的中介效应[J].中国慢性病预防与控制,2022,30(6):465-468.
YI M,JIANG D,JIA Y M,et al.Mediating effect of caregiver burden on self-care ability and symptom control in patients with chronic obstructive pulmonary disease[J].Chin J Prev Control Chronic Dis,2022,30(6):465-468.(in Chinese)
[8] GRANADOS-SANTIAGO M,ROMERO-FERNÁNDEZ R,CALVACHE-MATEO A,et al.Relationship between patient functionality impairment and caregiver burden:is there a cut off point for the severe COPD patient[J].Expert Rev Respir Med,2023,17(3):247-253.
[9] VENKATESAN P.GOLD COPD report:2025 update[J].Lancet Respir Med,2025,13(1):7-8.
[10] 孙婧,罗彩凤,魏青,等.中文版家庭照顾者照顾能力量表在肠造口病人照顾者中的信度及效度研究[J].护理研究,2018,32(8):1234-1238.
SUN J,LUO C F,WEI Q,et al.Study on reliability and validity of Chinese version of Family Caregiver Task Inventory of enterostomy patients[J].Chin Nurs Res,2018,32(8):1234-1238.(in Chinese)
[11] 王烈,杨小湜,侯哲,等.护理者负担量表中文版的应用与评价[J].中国公共卫生,2006,22(8):970-972.
WANG L,YANG X S,HOU Z,et al.Application and evaluation of Chinese version of zarit caregiver burden interview[J].Chin J Public Health,2006,22(8):970-972.(in Chinese)
[12] VITACCA M,MALOVINI A,BALBI B,et al.Minimal clinically important difference in Barthel Index dyspnea in patients with COPD[J].Int J Chron Obstruct Pulmon Dis,2020,15:2591-2599.
[13] 田甜. 老年慢性阻塞性肺疾病患者主要照顾者心理一致感、照顾负担及照顾能力相关研究[D].成都:成都医学院,2023.
TIAN T.Study on the sense of coherence,care burden and care ability of the main caregivers of elderly patients with chronic obstructive pulmonary disease[D].Chengdu:Chengdu Medical College,2023.(in Chinese)
[14] MUÑOZ-CRUZ J C,LÓPEZ-MARTÍNEZ C,ORGETA V,et al.Subjective caregiver burden and coping in family carers of dependent adults and older people:a systematic review and meta-analysis[J/OL].Stress Health,2024,40(4)[2025-09-10].https://doi.org/10.1002/smi.3395.
[15] OZSOY I,OZCAN KAHRAMAN B,ACAR S,et al.Factors influencing activities of daily living in subjects with COPD[J].Respir Care,2019,64(2):189-195.
[16] WIJNANT S R A,BENZ E,LUIK A I,et al.Frailty transitions in older persons with lung function impairment:a population-based study[J].J Gerontol A Biol Sci Med Sci,2023,78(2):349-356.
[17] NIU S Z,DING S L,WU S Q,et al.Correlations between caregiver competence,burden and health-related quality of life among Chinese family caregivers of elderly adults with disabilities:a cross-sectional study using structural equations analysis[J/OL].BMJ Open,2023,13(2)[2025-09-10].https://doi.org/10.1136/bmjopen-2022-067296. |
|
|
|
