| Objective:To investigate general condition and characteristics of Self-management behavior in patients with coronary heart disease (CHD) as well as the characteristics of illness Perceptions, and then to analyze their relationships with self-management Behavior of patients with CHD.Methods:196patients with CHD were recruited from cardiology department of a tertiary-care hospital in Shandong Province during March2013to October2013in a cross-sectional study. All patients were investigated with general information questionnaire; Coronary artery disease Self management scale (CSMS), the revised Illness Perception Questionnaire (IPQ-R) and then data were analyzed by SPSS16.0Results:1. Total score of Self-management Behavior of patients with CHD was80.26±11.11, and the entries average of each dimensions were behavior of daily life management (3.43±0.58), medical management behavior(2.75±0.38),emotional management (2.87±0.75) in the descending order.2. There were statistical differences of self-management behavior in different social demography characteristics and illness features of patients with CHD. Those who were with college degree educational level or above, retired, lived with their families, with per capital income of family>1000yuan monthly, had medical insurance, with more than three year disease course, with more than two complications, with a history of myocardial infarction and experienced PCI trended to demonstrate a higher score of self-management behavior compared with those who were with primary school, lived alone, with per capita income of family<1000yuan monthly, still at their post, joined in the rural cooperative care system, with less thanl year disease course, with no complication, with no a history of myocardial infarction and not experience PCI.3. The first part of illness perceptions in patients with CHD is disease identity: patients experienced most three symptoms are chest pain, chest discomfort, cold sweats. In the second part of illness perception contain seven dimension, entries average of each dimension were timeline:acute/chronic (3.56±0.30) scores, perceived consequences (3.14±0.63) scores, Treatment control (3.85±0.35), Personal control (3.66±0.46), Illness coherence(3.40±0.71),timeline cyclical (3.04±0.66),Emotional representation (3.21±0.67), and have a correlation between the dimensions. The three main factors of the cause subscale were behavior habits, environmental factors and psychological factors. Disease identity and disease medical management behavior were positive correlation (P<0.05), with correlation coefficient was0.196; acute and chronic of illness and disease medical management were positive correlation (P<0.01),with correlation coefficient was0.377; consequences scores and disease medical management behavior were positive.Correlation (P＜0.05), but consequences scores and emotional management were negative correlation (P＜0.05), and related coefficients were respectively0.186,-0.412.The score of treatment control was positively correlated with total score of self-management and the score of medical management(P＜0.01),and the related coefficient were0.296,0.338;The score of personal control was positively correlated with total score of self-management,daily life management, medical management (P＜0.05), and the related coefficient were respectively0.207,0.236,0.208;The score of Illness coherence was positively correlated with total score of self-management and each dimension(P<0.05), and the related coefficient were respectively0.497,0.36,0.525,0.291;The score of timeline cyclical was negatively correlated with total score of self-management, emotional management(P<0.05), and was positively correlated with medical management,and the related coefficient were respectively-0.230,-0.540,0.255; The score of emotional representation was negatively correlated with total score of self-management and the score of each dimension(P<0.05), and related coefficients were respectively-0.356,-0.413,-0.232,-0.258; The score of behavioral factors was positively correlated with total score of self-management and daily life management(P<0.05), and the related coefficient were respectively0.269,0.210;The score of psychological factors was negatively correlated with emotional management(P<0.05), and the related coefficient was-0.209; The score of physical factors was positively correlated with total score of self-management, daily life management, medical management(P<0.05), and the related coefficient were respectively0.322,0.306, and0.336.4. Multiple regressions were used to analyze the factors that influencing self-management behavior and its dimensions. Monthly income of family, treatment methods, the number of complications, illness coherence were predictive factors of self-management behavior (R2=0.652); treatment methods, the number of complications, personal control, behavioral factors, illness coherence were predictive factors of daily life management (R2=0.537); Monthly income of family, the number of complications,treatment control, emotional representation were predictive factors of disease medical management (R2=0.522);cardiac arrhythmias, perceived consequences, timeline cyclical, psychological factors were predictive factors of emotional management (R2=0.664).Conclusion:1. The general level of self-management behavior of patients with CHD was middle level, and we should strengthen health education of patients who are at still at their post, with primary school educational level, lived alone, with per capita income of family<1000yuan monthly, with less thanl year disease course, joined in the rural cooperative care system, with more complications、 with cardiac arrhythmias and experienced PCI in order to improve their positivity in the practice of self-management behavior and decrease theirs negative emotion.2. The ability to identify symptoms of CHD was on a good status, the patient can recognize the typical symptoms of CHD. Patients perceived their illness to be chronic, have more confidence in the treatment, most patients could better understand of their illness, patients’understanding of a particular aspect of the disease affect understanding of other aspects; behavioral factors, psychological factors were attributed to the main cause of disease.3. Per capital monthly income of family had positive prediction for self-management behavior and medical management; experienced PCI had negative prediction for self-management behavior and daily life management; complications had positive prediction for self-management behavior, The number of complications, daily life management, medical management. Illness perception of patients had prediction for self-management behavior; the patients who had a rich experience of illness, had been fully understanding to disease and had a good personal control could better practice self-management behavior. Patients who perceived serious consequences and symptoms occur repeatedly often hold negative disease perception and negative emotional representation. If the patient attributed to behavioral factors for the disease, they were relatively easy to implement in daily life management, if the cause of the patient due to the psychological factors, they often had a bad mood and could not manage emotions effectively. |
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