目的 调查稳定期慢性阻塞性肺疾病（chronic obstructive pulmonary disease,COPD）患者个人掌控感现状，分析其与应对方式的相关性，为制订针对性的干预和服务策略提供依据。方法 通过便利抽样纳入某三级甲等医院340例稳定期COPD患者为研究对象，采用一般资料调查问卷、个人掌控感量表（personal mastery scale,PMS）、社会支持评定量表、特质应对方式问卷进行调查。结果 340例稳定期COPD患者PMS得分（24.23±4.98）分、积极应对方式得分（35.71±6.43）分、消极应对方式得分（27.60±6.73）分。不同性别、年龄、文化程度、职业、医疗付费方式、长期居住地、家庭人均月收入、居住地周围医疗机构、病程、肺康复训练、合并症、抑郁、COPD患者自我评估测试（COPD assessment test，CAT）评分、改良版英国医学研究委员会呼吸问卷得分、肺功能分级、综合评估分级、过去1年急性加重次数、过去1年急性加重住院史、自理能力等级、社会支持等级的稳定期COPD患者PMS得分差异有统计学意义（均P＜0.05）；且性别、职业、CAT评分、综合评估分级、生活自理能力和社会支持是PMS独立影响因素（均P＜0.05）。PMS与积极应对方式呈正相关（r=0.548，P＜0.01），与消极应对呈负相关（r=-0.513，P＜0.05）。结论 稳定期COPD患者PMS处于中等水平，且受多种因素影响，PMS与应对方式具有相关性。临床应重视评估患者的PMS，针对性制订干预措施，提高患者的积极应对方式，减少临床不良事件。

Objective To explore the status quo of personal mastery among stable chronic obstructive pulmonary disease (COPD) patients,to analyze its correlation with coping styles,and to provide a basis for targeted interventions and service strategies. Methods By the convenience sampling method,340 stable COPD patients were selected,and a survey was conducted by general information questionnaires,the Personal Mastery Scale (PMS),Social Support Rating Scale,and Trait Coping Style Questionnaire.Results The PMS score of the subjects was (24.23±4.98),with positive coping style score of (35.71±6.43) and negative coping style score of (27.60±6.73).Differences in PMS scores were statistically significant (all P＜0.05) for gender,age,education level,occupation,healthcare payment method,long-term residence,average monthly household income,proximity to medical institutions,disease duration,pulmonary rehabilitation training,comorbidities,depression,COPD Assessment Test(CAT) score,modified British medical research council score,pulmonary function classification,comprehensive assessment,frequency of acute exacerbations in the past year,history of acute exacerbation hospitalization in the past year,self-care ability level,as well as social support level among stable COPD patients.Gender,occupation,score,comprehensive assessment,self-care ability level,and social support were independent influencing factors for PMS (all P＜0.05).PMS was positively correlated with positive coping style (r=0.548,P＜0.01) and negatively correlated with negative coping style(r=-0.513,P＜0.05).Conclusions The PMS of stable COPD patients is at a moderate level,influenced by various factors,and is correlated with coping styles.It is important to focus on assessing the PMS of patients in clinical practice,develop targeted interventions,enhance positive coping strategies,and reduce adverse clinical events.

R473.56

四川省卫生健康委医学科技项目（21PJ076）