Study On Illness Uncertainty And Its Influential Factors Among Stroke Inpatients And Family Caregivers

Stroke is the most common cerebrovascular disease which has several characteristics,such as delayed healing, repeated relapse, and poor prognosis. Stroke survivors may suffer from a variety of physical, emotional, and social behavior disability. In the long course of treatment and rehabilitation, disease recurrence and aggravating, complex maintenance treatment, and long-term rehabilitation exercise can make patients and family caregivers have sense of illness uncertainty. Illness uncertainty not only affects patients' compliance to treatment, increase their psychological stressors and negative emotions, but also decrease the quality of life among stroke patients. It will also have negative influence on the psychological social adaptation of family caregivers and lead to the ability and quality of care reduced. As a result, patient's rehabilitation and family caregiver's quality of life will be greatly influenced. Therefore, aimed at providing evidences for medical workers to take effective and targeted measures, stroke inpatients and family caregivers weresurveyed to understand the current status of illness uncertainty and explore its influential factors. The relationships between patients and their family caregivers' characteristics related to each other's illness uncertainty were also analyzed.Objectives:1. To understand the current status and influential factors of illness certainty among stroke inpatients and family caregivers.2. To explore the mutual characteristics of stroke patients and family caregivers related to each other's illness uncertainty.Methods:Stroke patients and family caregivers were sampled from two general hospitals in Xi'an. The general condition questionnaire, mishel uncertainty in illness scale for adults,mishel uncertainty in illness scale for family member, barthel index, state anxiety inventory, self-rated depression scale, social support rating scale, and simplified coping style questionnaire was used to evaluate the status and influential factors of illness uncertainty among patients and family caregivers. The data was analyzed by SPSS 17.0.The descriptive analysis, independent sample t-test, chi-square test, pearson correlation analysis and analysis of variance were used to analyze the data. There was a significant difference at the 0.05 level.Results:1. Illness uncertainty of stroke inpatients and family caregivers The whole level of illness uncertainty in stroke inpatients was moderate. The average score was(74.37±9.22). Among 414 patients, there were 95.2% and 2.9% patients with moderate and high level of illness uncertainty respectively. The primary source of illness uncertainty among patients was the ambiguity of illness symptoms.The whole level of illness uncertainty in family caregivers was also moderate. The average score was(90.83±9.08). There was 97.8% family caregivers with moderate level of illness uncertainty. The primary source of illness uncertainty among family caregivers was unpredictable the process and prognosis of illness as well as ambiguity of illnesssymptoms.2. The influential factors of illness certainty among stroke inpatients and family caregivers.The illness uncertainty of stroke inpatients was not only affected by patients' occupation, residence, average monthly incomes of family members, course of disease,combination with other diseases, activities of daily life, anxiety and depression disorders,but also affected by family caregivers' occupation, physical health and negative coping styles.The illness uncertainty of family caregivers was not only affected by family caregivers' occupation, the level of economic stress, social support, coping style, anxiety and depression disorers, but also affected by patients' activities of daily life, anxiety and depression disorders.Conclusion:1. Both levels of illness uncertainty among stroke inpatients and family caregivers are moderate. The primary source of illness uncertainty among patients is the ambiguity of illness symptoms. The primary source of illness uncertainty among family caregivers is unpredictable the process and prognosis of illness as well as ambiguity of illness symptoms.2. The illness uncertainty of stroke inpatients and family caregivers are influenced by several factors. These influential factors may come from patients or their family caregivers.Patients' activities of daily life, anxiety and depression disorders and family caregivers' occupation, coping style are the common influential factors.3. Both stroke inpatients and their family caregivers are all faced with illness uncertainty.Early prevention and treatment interventions for them will be benefit to patients' recovery.