Ekici等研究发现，哮喘患者的生活质量和情绪状况较差，心理社会因素在其中起着一定的影响作用。Freeman等的初步研究表明对哮喘患者的知识教育和意象想象等心理干预能够在一定程度上预防和控制哮喘以及提高患者的生活质量和情绪状况。本研究的主要目的是了解哮喘患者的生活质量状况及其影响因素，通过临床实验验证教育管理和心理干预方案的效果，探讨教育管理和心理干预如何提高哮喘患者的生活质量。在实验设计和被试筛选时不仅对人口学和医学变量，同时也对心理变量进行了均衡性比较。运用随机对照的方法，形成2 (实验组，对照组)×3 (治疗前，治疗后，出院3个月后)的因素设计模型。实验组除进行常规药物治疗外，再加入教育管理及心理干预；对照组只进行常规药物治疗；每组的测查时间分为治疗前、治疗后和出院后3个月三个观察点。 同时，为了更全面地了解哮喘患者的心理社会因素、生活质量状况以及影响因素，本研究除了对住院患者进行干预研究外，还采用哮喘生活质量评估表、艾森克人格问卷、医用应对问卷、社会支持评定问卷、简式简明心境问卷和哮喘疾病知识问卷对门诊和住院患者进行心理社会因素和生活质量的问卷调查。发放问卷819份，共获得有效问卷769份，其中门诊患者395份；住院患者问卷374份(实验组228份、对照组146份)。运用SPSS10.0统计分析软件分析数据。 结果表明： 1.生活质量总均分为113.00±25.85；每题均分为3.23，处在5点量表的中间位置。 2.简式简明心境问卷总分23.16±20.92，紧张、抑郁、愤怒、疲乏、混乱负性情绪等因子上得分较高，而在正性情绪精力维度上得分较低。 3.人格因素中的神经质和应对方式中的屈服应对与生活质量和情绪显著相关，回归分析和路径分析显示屈服应对和神经质是对生活质量的影响最大的两个因素。 4.实验组和对照组之间的比较显示：在干预后及干预三个月后，实验组在生活质量、情绪和哮喘知识上都要显著好于对照组患者。 5.治疗前、治疗后和治疗三个月后的差值比较显示：实验组和对照组在生活质量、情绪状况和哮喘知识上都有提高，但实验组提高的分值要显著大于对照组。 6.回归分析显示哮喘患者屈服应对的减少和对支持利用度的提高是干预起效果的两个最重要的因素。 综合以上结果，可得出如下研究结论： 1.哮喘患者的生活中时常地会出现各类活动受限、哮喘症状及生理心理反应，整体生活质量状况和情绪状况偏差。 2.屈服应对和神经质性人格是影响哮喘患者生活质量的两个最重要的因素，对支持的利用度以及客观支持、内外向、精神质等也会在一定程度上影响哮喘患者的生活质量。 3.经过干预的哮喘患者，其整体生活质量和各功能指标都提高了，尤其情绪状况有明显的改善。 4.教育管理和心理干预方案经实验研究证明是有效的、可行的，适应性较广，临床实践中病人的反映也比较好，但在针对性上还有待进一步改进。 关键词：哮喘患者，教育管理，心理干预，心理社会因素，生活质量 情绪

 The quality of life (QOL) and the mood of asthma patients are poor, which, to a great degree, were attributed to social-psychological factors (Ekici et al, 2007). The preliminary studies by Huang (2007) and Freeman et al (2005) have showed that knowledge education and psychological interventions, such as the imagination, were effective to prevent, control and improve QOL and the mood of asthma patients. This study was attempted to find out the status quo of QOL and its influencing factors in asthma patients. The effects of educational management and psychological interventions on QOL have been verified through clinical experiments on asthma patients with their mechanisms explored. The balanced comparison was adopted not only for the demographical and medical variables, but also for the psychological variables in experiment design and subject selection. The experiment was designed in a pattern of 2X3, with two levels including the experimental group and the control group and with three factors being pre-treatment, post-treatment, and 3-month after discharge from the hospital. Educational management and psychological interventions were added to the experimental group besides the conventional medications, while the control group received only the conventional medications. The timing for observations in each group was at pre-treatment, post-treatment, and 3-month after discharge from the hospital. To gain a clear picture of the social-psychological factors, the status quo of QOL and the influencing factors in asthma patients, six questionnaires were used in both the outpatients and the inpatients. The questionnaires included Asthma Quality of Life Questionnaire (AQLQ), Eysenck Personality Questionnaire (EPQ), Medical Coping Modes Questionnaire, Social Support Scale, Profile of Mood States (POMS), and Asthma Knowledge Questionnaire. The relevant demographic and medical data of the patients had also been collected by means of the questionnaires. A total of 819 questionnaires were distributed with 769 valid questionnaires received, 395 from outpatients and 374 from inpatients (228 from the experimental group and 146 from the control group). The collected data were entered into SPSS 10.0. The results show that 1)The total average of QOL is 113.00±25.85; the average for each item is 3.23, which is in the middle of five-point scale. 2)The total score of POMS is 23.16±20.92; scores of the negative emotions including tension, depression, anger, fatigue, confusion are relatively high, whereas scores in the vigor dimension of the positive emotions are relatively low. 3)There's a significant correlation between neuroticism personality and resignation coping style, and both of them are the most influential factors on QOL showed by both regression analysis and path analysis. 4)There's a significant improvement in AQLQ, POMS and AKQ in subjects of the experimental group both at post-treatment and at 3-month; 5)The difference between pre-treatment, post-treatment and 3-month shows that there is significant improvement in AQLQ, POMS and AKQ in subjects of both the experimental group and the control group. The improvement for the subjects of experimental group is much more than the control group. 6)The regression analysis shows that the reduction of acceptance-resignation and the improvement of support utilization are both significantly correlated with the effect of interventions. Based on the above results, the following conclusions can be drawn: 1)Varying degrees of restriction on activities, asthma symptoms, physiological and psychological reactions appear from time to time in the asthma patients' daily life, which leads to a poor QOL and mood. 2)Resignation coping style and neuroticism personality are the most influential factors on the QOL of asthma patients. To some extent, utilization of support, objective support, psychoticism, as well as introversion and extraversion may also affect the QOL of asthma patients. 3)The overall QOL and the functional parameters of asthma patients, especially their emotional status, improve significantly after the interventions. 4)The programs of educational management and psychological interventions have proved to be effective and feasible with wide adaptability. Most patients investigated gave a high opinion of the programs. However, the pertinence of the programs still remains to be further improved. KEY WORDS: Asthma patient, Quality of life, Educational management, Psychological intervention, Psychosocial factor