The Current Status of Social Isolation and the Caregiver Compassion Fatigue in Elderly COPD Patients

老年慢性阻塞性肺病患者的社会孤立现状及照护者同情疲劳

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Abstract

BACKGROUND: Chronic obstructive pulmonary disease (COPD) significantly affects elderly individuals, often leading to social isolation and impacting quality of life. Family caregivers play a crucial role but may experience compassion fatigue (CF), potentially exacerbating patient outcomes. This study investigates social isolation in elderly COPD patients and examines the impact of caregiver compassion fatigue. METHODS: We conducted a retrospective analysis of 200 elderly COPD patients from January 2018 to December 2022 at West China Hospital of Sichuan University. Participants were divided into poor prognosis (n = 109) and good prognosis (n = 91) groups based on outcomes within 90 days of admission. Caregiver compassion fatigue was assessed using the Professional Quality of Life Scale (ProQOL), categorizing patients into low (n = 125) and high (n = 75) caregiver fatigue groups. Social isolation was measured using the Generalized Alienation Scale (GAS) and the Multidimensional Scale of Perceived Social Support (MSPSS). Patient outcomes included pulmonary function tests, the 6-Minute Walk Test (6MWT), and psychological assessments using the Hospital Anxiety and Depression Scale (HADS), Connor-Davidson Resilience Scale (CD-RISC), and the Satisfaction with Life Scale (SWLS). RESULTS: No significant demographic differences were observed between GP and PP groups. The PP group exhibited higher GAS scores (P = 0.017) and lower MSPSS scores (P = 0.045), indicating greater social isolation. Caregivers of PP patients reported higher compassion fatigue and burnout levels (P = 0.007; P = 0.003). Elevated caregiver compassion fatigue correlated with poorer patient outcomes, including decreased exercise tolerance (P = 0.021) and increased anxiety and depression (P = 0.008 and P = 0.045, respectively). Lower resilience and life satisfaction scores were observed in patients with caregivers experiencing high compassion fatigue, highlighting the impact on psychological well-being. CONCLUSION: Elderly COPD patients often experience significant social isolation, exacerbated by high levels of caregiver compassion fatigue.

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