Relative Study Of Uncertainty And Coping Styles And Family Supports Of Patients Undergoing Hemodialysis

Objective:To investigate the status of uncertainty in illness,coping styles and family supports of patients undergoing hemodialysis.And to explore the factors influencing the uncertainty in individual characteristics,as well as the correlation between ill uncertainty and coping styles and the correlation between ill uncertainty and family supports .Its aim is to decrease patients'uncertainty and increase their confidence over disease,and then improve patients' quality of life as its scientific evidence.Methods:By convenient sampling,133 patients undergoing hemodialysis in five tertiary hospital of HeBei proveince were selected in the study. Four instruments were used to collect data,including the demographic form, the Mishel Uncertainty in Illness Scale for Adult, the Medical Coping Models Questionnair,and Modified Procidano Family Support Scale. The data were entered into the Statistical software Package of Social Science(SPSS) 13.0 for the descriptive and inferential statistical analysis of the feedbacked questionnairs. The statistical methods included descriptive analysis , t-test,one-way analysis of variance (ANOVA), nonparametric test,multiple regession analysis and Spearman correlation analysis.Results: There are 140 people who have done the questionnaire,and 133 of them are valid questionnaires,including 66 men and 67women. The patients' age is in the range from 18 to 72 years old.The results showed as following: 1 The score of the total uncertainty ranged from 33 to96 (mean=66.01, S.D.=11.99).The score of the unpredicatability factor ranged from 20 to58 (mean=40.29, S.D.=7.34).The score of the complexity factor ranged from 11 to 38(mean=25.72, S.D=5.41).The uncertainty in illness was in the medium status. 2 Based on the study results by t-test and one-way analysis of variance,there had discrepancy of uncertainty scores among different gender;.The relationship of the family members with the patient was significantly related to differences in total uncertainty and its two factors.The times of dialysis every week also significantly effected the discrepancy among the total uncertainty and its two sub-factors.3 Based on the study results by nonparametric test, patients in different age groups influenced the results of the total uncertainty and the complexity factor.The education level was related to differences in the total uncertainty scores.The effects of discrepancy that the wealth status and medical payment terms caused on the level of the total uncertainty and its two sub-factors had statistical significance.4 Multiple regession analysis indicated that the following factors can significantly influence the total uncertainy and the unpredicatability factor.They were the times of dialysis and monthly income.Using similar analysis, only monthly income variances were entered into the complexity factor equation of multiple regession .5 Among three coping styles (confrontation,avoidance and resignation coping mode ),the score of confrontation was highest.It indicated that the most of patients undergoing hemodialysis took confrontation coping style.6 According to the results of Spearman correlation analysis, the total uncertainty was significantly positive correlation to resignation coping mode(r=0.436,p< 0.01)The unpredicatability factor has a significantly positive correlation to resignation (r=0.329,p<0.01).The foregoing shows that,as the score of resignation coping mode increasing, the scores cf total uncertainty and the unpredicatability factor were increased correspondingly.7 Spearman correlation analysis indicated that the family surport was significantly negative corrlation to the uncertainty(r=-0.452,p<0.01)the unpredicatability factor(r=-0.439,p<0.01), and the complexity factor(r=-0.448,p<0.01).Conculsion:The score of the uncertainty was in the medium standard among patients with hemodialysis,which is worth our paying attention on.There are many factors influencing the uncertainty, consisting of age,gender,income, the times of dialysis and the times of patients to be hospitalized.Otherwise, the resignation coping mode had positive correlation to patiecnts'uncertainty. The study suggested that the supports coming from patients'family have a significant effect on the level of uncertainty in illness.Therefore,we should not only take measures of mental nursing and guide to unsimilar patients in different ages,gender,income and so no,but also regard the family members of patients into our work scope . We are to co-create effective health supporting system with patient's family, in order to the decrease their uncertainty in illness , influencing coping style in positive way,and strengthening patient's confidence over illness. Further more, to level up the living quality of patients.