Compliance of home pulmonary rehabilitation training in patients with stable interstitial lung disease and its influencing factors
Objective To analyze the compliance of home pulmonary rehabilitation training and its influencing factors in patients with stable interstitial lung disease(ILD).Methods A total of 486 patients with stable ILD as the research subjects.Questionnaires were distributed to patients before discharge.The questionnaire contents included general information(gender,age,place of residence,education background,disease course,smoking status,diet status,drinking status,cost-bearing method,pulmonary rehabilitation knowledge,family support,etc.),the social support rating scale(SSRS)was used to assess family support,self-efficacy assessment scale was adopted to evaluate self-efficacy,Hamilton Anxiety and Depression Scale(HAMD,HAMA)for negative emotions,and a 6-minute walk experiment(6 MWT)before discharge for exercise capacity,pulmonary function was measured using a lung function tester[forced expiratory volume in the first second(FE V1),ratio of forced expiratory volume in the first second to forced vital capacity(FEV1/FVC)and peak respiratory flow(PEF)];pulmonary function prognosis was assessed based on patient ILD related symptoms.The compliance of pulmonary rehabilitation was evaluated by outpatient or telephone call 4 weeks after discharge.Binary Logistic regression model was used to analyze the related influencing factors of rehabilitation training compliance.Results A total of 475 valid questionnaires were collected,with a recovery rate of 97.74％.There were 126 cases of home pulmonary rehabilitation training compliance and 349 cases of non-compliance among patients with stable ILD,and the compliance rate was 26.52％.Univariate analysis showed that there were statistical differences in age,education background,disease course,pulmonary rehabilitation knowledge,family support,self-efficacy,anxiety,FEV1/FVC,PEF,and lung function prognosis among patients with stable ILD in different pulmonary rehabilitation training compliance status(P＜0.05).Among them,proportion of patients in non-compliance group with following status was higher than that of compliance group:60 years old and above,education background of junior middle school or below,disease course of 4 years or more,never exposed to pulmonary rehabilitation,low-level family support,low-level self-efficacy,mild or moderate/severe anxiety,poor prognosis of pulmonary function(P＜0.05),while its FEV1/FVC and PEF were lower than compliance group,differences were statistically significant(P＜0.05).logistic multivariate analysis showed that education level,course of disease,pulmonary rehabilitation knowledge,family support and self-efficacy were the influencing factors of home pulmonary rehabilitation training compliance in patients with stable ILD.Patients with education level of junior middle school and below,disease course of 4 years and above,no knowledge of pulmonary rehabilitation,low family support,low self-efficacy,anxiety,low level FEV1/FVC and PEF,poor prognosis of pulmonary function had poor home pulmonary rehabilitation training compliance.Conclusion The compliance of home pulmonary rehabilitation training in patients with stable ILD was low,which was affected by factors such as education background,pulmonary rehabilitation knowledge,family support,self-efficacy,anxiety,basic conditions of pulmonary function and its function prognosis.
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