Path analysis of the effect of positive psychological capital on health-promoting lifestyle in patients with COPD after pulmonary rehabilitation: An observational study

Abstract

To investigate the effect of positive psychological capital on the health-promoting lifestyle of patients with chronic obstructive pulmonary disease (COPD) and the intermediary effects of life satisfaction and learned helplessness. A total of 482 patients who completed the pulmonary rehabilitation course at the Nantong Sixth People’s Hospital of Jiangsu Province were surveyed using a self-designed questionnaire battery, encompassing the positive psychological capital, health-promoting lifestyle, life satisfaction, and learned helplessness scales. A total of 469 of the 482 questionnaires distributed were effectively returned, leading to an effective response rate of 97.3%. The mean scores on the positive psychological capital, life satisfaction, learned helplessness, and health-promoting lifestyle scales were 105.56 ± 10.44, 19.89 ± 6.33, 50.14 ± 5.47, and 104.22 ± 10.44, respectively. The structural equation model demonstrated good fit indexes. The path analysis revealed that positive psychological capital had a direct effect of 0.431 on health-promoting lifestyle, while life satisfaction and learned helplessness had a mediating effect on this relationship (both P < .05). Patients with COPD have low levels of positive psychological capital and health-promoting lifestyle. Thus, addressing psychological problems and providing continuous rehabilitation nursing to strengthen the psychological construct are essential in this patient group. Moreover, the positive psychological capital of patients with COPD can directly predict their health-promoting lifestyle and exert an influence via the chain mediating effect of life satisfaction and learned helplessness. Therefore, clinical medical staff should assess the positive psychological capital of patients with COPD and adjust the daily rehabilitation activities according to the patients’ mental state. Furthermore, enhancing the patients’ life satisfaction by employing diverse strategies to reduce learned helplessness can notably improve the health-promoting lifestyle of those with COPD.