Factors Rerated to Acute Exacerbation in Patients with Chronic Obstructive Pulmonary Disease of Ranong Hospital.

Abstract

This descriptive research aimed to investigate factors associated with acute exacerbations among patients with chronic obstructive pulmonary disease (COPD) at Ranong Hospital. The sample consisted of 294 patients primarily diagnosed with COPD and acute exacerbation (ICD-10 codes), selected through purposive sampling. Data collection was conducted from October to December 2024. The research instrument was a structured questionnaire comprising sections on general information, knowledge, and practices. The instrument’s content validity was verified with an IOC range of 0.67–1.00, and reliability was acceptable with a KR-20 of 0.617 and Cronbach's Alpha of 0.752. Data were analyzed using descriptive statistics and Chi-square tests.

The results revealed that the majority of the participants were female (52.72%) with an average age of 65.04 years. Most had been diagnosed for 5–10 years (69.39%) and exhibited a moderate level of disease severity (80.27%). Regarding knowledge and practice levels, most participants demonstrated high levels of knowledge (97.28%), but their self-management practices were predominantly at a moderate level (94.90%). Factors significantly associated with acute exacerbations (p < .05) included demographic factors (age over 60 years, unemployment, and insufficient income), clinical factors (history of pneumonia and emergency nebulization within the past year), and behavioral/environmental factors (smoking and having family members who smoke). Conversely, gender, education level, comorbidities, and exposure to pollution from burning waste or incense showed no significant association with exacerbations in this study.

Recommendations from this research suggest that nurses and multidisciplinary teams should prioritize holistic patient assessment and care, focusing on both physical and psychological symptom management. Pulmonary rehabilitation programs should be established to delay lung function decline. Additionally, providing education to family members to reduce secondhand smoke exposure is essential to decrease exacerbation rates and enhance long-term patient safety.