Investigation of the factors affecting psychosocial adjustment to chronic obstructive pulmonary disease (COPD)

Introduction: COPD is a public health problem that has a significant mortality and morbidity rate with chronic cough, respiratory distress and sputum production associated with airway obstruction in the bronchi, a progressive and life-threatening severe pulmonary disease, starting with dyspnea, continues with exacerbations. COPD is not only physical but also a chronic taboo with biological, mental, social, familial and environmental effects. For this reason, individuals with COPD are experiencing difficulties in carrying out their daily life activities as well as experiencing many psychosocial problems. Objective : In this study, we aimed to determine the factors affecting the psychosocial adjustment of individuals with COPD, health care adaptation, occupational environment, family environment, sexual relations, extended family relationships, social environment and psychological pressure. Material and Methot: The study was conducted with the participation of 230 patients between August-October 2017 in the COPD clinic, Surreyapaşa Chest Diseases and Chest Surgery Training and Research Hospital. The data were collected using the COPD Asseement Test (CAT), the Psychosocial Adaptation-Self-Report Scale (PAIS-SR) and the interview form containing the characteristics of the patients and the SPSS 21.0 package program in evaluating the data. Descriptive statistics; (number, percentage, mean, standard deviation) one way analysis of variance (ANOVA), Kolmogorov-Smirnov test, Independent samples T-test, Post-Hoc Tukey test, Chi-square independence test were used in the 95% confidence interval and the significance level was taken as 0,05 and p <0,05 level was accepted as a sign of significant difference It was. Ethical committee approval was obtained from the research. Results: The mean age was 66 ± 10 and 76.5% were male, 77% (n = 177) married, 52.2% (n = 120) primary school graduates and 64.3% (n = 148) (n = 118), and 67.8% (n = 156) did not participate in social activities, 88.3% of the patients (n = 203) were found to have poor psychosocial adaptations and the worst harmonized psychosocial areas were found to be adaptable to health care and occupational environment and the best fit was wide family relationships. Conclusions and Recommendations: In our study, female gender, being over 66- 75 years old, being single, having no children, having 1 child, low education level, working status, poor living conditions, living alone, low socioeconomic status, quitting smoking due to COPD, getting information about the disease, being over 7- 11 years and over COPD, presence and number of diseases accompanying COPD, physical loss of power, frequency of admission to the hospital, regular check-ups, use of ancillary devices for treatment, presence of ancillary person, participation in social activities and withdrawal from the home, high level of insomnia, level of COPD exposure to libido, level of symptom seen and frequency, were identified as factors that changed adjustment. In this study, it is suggested to provide education about illness to increase patient compliance, to control symptoms of COPD, to treat and care for accompanying diseases and symptoms, and to support patients' participation in social activity groups. Key words: COPD, Chronic Pulmonary Disease, Psychosocial Adjustment, Factors, Nursing