Objective To explore the effects of cognitive schema health education combined with family-accompanied narrative therapy on the disease perception and symptom burden of elderly patients with chronic obstructive pulmonary disease（COPD）. Methods Eighty-eight cases of elderly COPD patients admitted to a hospital in Zhengzhou from January 2018 to December 2020 were selected and divided into an observation group and a control group using a random number table

with 44 cases in each group. Patients in the control group were cared for with family-accompanied narrative therapy

and patients in the observation group were cared for with cognitive schema health education in addition; the intervention continued in both groups for 2 weeks. Patients in the two groups were compared before and after the intervention for memory symptom assessment scale（MSAS）

brief illness perception questionnaire（BIPQ）

medical coping modes questionnaire（MCMQ） scores

lung function and the occurrence of lung infections during the intervention. Results After the intervention

the scores of MSAS in both groups were lower than those before the intervention

and those in the observation group were lower than those in the control group

with statistically significant differences（P<0.05）. The levels of the forced expiratory volume in 1 second（FEV1）

forced vital capacity（FVC） and FEV1/FVC were higher in both groups than before the intervention and higher in the observation group than in the control group

with statistically significant differences（P<0.05）. The lung infection rate of patients in the observation group was 9.09%

which was lower than that of 25.00% in the control group

and the difference was statistically significant（χ2=3.938

P=0.047）. Conclusion Cognitive schema health education combined with family-accompanied narrative therapy helps to improve disease perception

enhance disease coping and pulmonary function

and reduce the level of symptom burden in elderly COPD patients.