Illness Uncertainty And Its Influential Factors Among Liver Cirrhotic Inpatients And Family Caregivers

ObjectiveThe study aimed to investigate the current status of illness certainty among liver cirrhosis inpatients and their family caregivers and to find the influential factors from mutual characteristics including depression,anxiety and perceived social support,so as to analyze the related factors of illness certainty among liver cirrhosis inpatients and their family caregivers,to reduce illness certainty and to provide intervention data support of implement the disease.MethodsThis was a cross-sectional study.The liver cirrhosis inpatients and their family caregivers were sampled from a top three hospitals in Ji'nan.The general condition questionnaire,Mishel Uncertainty in Illness Scale for Adults(MUIS-A),Mishel Uncertainty in Illness Scale for Family Member(MUIS-FM),Patient Health Questionnaire-9(PHQ-9),Generalized Anxiety Disorder-7(GAD-7)and Perceived Social Support Scale(PSSS)were used to evaluate the status and influential factors of illness uncertainty among patients and family caregivers.The data was analyzed by SPSS 20.0.The descriptive analysis,paired samples t-test,chi-square test,pearson correlation analysis and analysis of variance and were used to analyze the data.There was a significant difference at the 0.05 level.Results(1)The whole level of illness uncertainty in liver cirrhosis inpatients was high,the average score was(84.82�12.92).The important factor affecting illness uncertainty among patients was the lack of information uncertainty.The average score of illness uncertainty in family caregivers was(92.49�12.66).The primary source of illness uncertainty among family caregivers was unpredictable the process and prognosis of illness as well as ambiguity of illness.Among patients and family caregivers,there were 86.0%and 14.0%subjects with moderate and high level of illness uncertainty respectively.(2)In inpatients,the average score of depression was(6.88�5.29),the score of anxiety was(5.27�4.10),the positive rate of depression and anxiety were 62.0%and 49.3%respectively.In family caregivers,the average score of depression was(6.88�5.29),the score of anxiety was(5.27�4.]0),the positive rate of depression and anxiety were 63.3%and 48.7%respectively.(3)For liver cirrhosis inpatients,the average score of perceived social support was(59.39�13.58).For family caregivers,the average score of perceived social support was(60.33�12.56).93.3%of the inpatients and 90.0%of the family caregivers had a social support with moderate level.(4)The results of one-factor analysis of variance showed that the differences in uncertainty in illness of patients with liver cirrhosis in education level(F=6.568,P=0.002)and course of disease(F=2.834,P=0.040)and the marital status of the family(t=-2.256,P=0.026)had statistical significance.The results of hierarchical linear regression shows that the illness uncertainty of cirrhosis inpatients was not only affected by patients' social support(?=-0.269,P=0.045),but also affected by caregivers' illness uncertainty(?=0.380,P<0.001).(5)The results of one-factor analysis of variance showed that the differences in uncertainty in illness of family caregivers in family's identity(?=3.355,P=0.021)as well as some patients' characteristics(sex,age,occupation,education level and course of disease)(P<0.05).The degree of the patient's education had an influence on the unpredictable dimension score of the family disease(F=4.734,P=0.010).At the same time,the marital status of the patients was different.The scores of their family members in the total score of the uncertainty of the disease and the uncertainty and complexity were also significantly different(P<0.05).The patient's course was different,and the family members were inaccurate in the disease(F=3.338,P=0.021).There was also a significant difference in the scores of fixation and information deficiency(F=4.207,P=0.007).The results of hierarchical linear regression shows that the illness uncertainty of family caregivers was affected by self-perceived friend support(?=-0739,P=0.036),but also affected by the patients' family support(?=-0.700,P=0.031)and the patients'illness uncertainty(?=0.333,P<0.001).Conclusions:(1)Both levels of illness uncertainty among liver cirrhosis inpatients and their family caregivers was moderate with relative high level.The primary source of illness uncertainty among patients and families is lack of unpredictable the process and prognosis of illness.(2)The illness uncertainty of liver cirrhosis inpatients and family caregivers are influenced by several factors such as themselves and the general demographic data,anxiety,depression and social support.These influential factors may come from patients or their family caregivers.(3)The illness uncertainty of liver cirrhosis inpatients and family caregivers were influenced by each other.It suggests that the medical staff should not only pay attention to the illness uncertainty of the disease in the hospitalized patients with liver cirrhosis,but also pay attention to the illness uncertainty experienced by their family caregivers in order to carry out comprehensive intervention as early as possible.