Study On Status Quo And Influencing Factors Of Self-management In Patients With Coronary Heart Disease In Rural Areas

ObjectivesTo investigate the status quo of self-management in patients with coronary heart disease in rural areas,the relationship between self-management and simple coping style and social support was analyzed.The main influencing factors were analyzed in this paper to provide reference for improving the level of self-management,which can reducing the rate of re-hospitalization and improving the quality of life of patients with coronary heart disease.MethodFrom May 1,2018 to December 31,2018,rural patients who met the inclusion and exclusion criteria in the Department of Cardiovascular Medicine,a tertiary A general hospital in Changsha,Hunan Province were selected as the study subjects.Subjects were surveyed using a general condition questionnaire,a coronary heart disease self-management scale,a social support rating scale and a simple coping style questionnaire.Results firstly were entered into EXCEL database,and the data were analyzed by SPSS25.0 software.The data of gender,nationality,marital status and other counts were expressed by frequency,composition ratio and the data of self-management total score and dimension score were expressed by mean and standard deviation.Analysis of variance was used for one-way analysis,Pearson correlation analysis and Spearman correlation analysis were used for correlation analysis and multiple linear regression analysis was used for influence factor analysis.Results(1)The total score of self-management is(46.85±12.37)points,the score of each dimension is from high to low,the score of daily life management is(63.45±14.09)points,the score of emotion management is(50.75±17.52)points,and the score of medical management of diseases is(42.69±19.61)points.(2)The positive coping style average score of the study subjects was(1.57±0.62)points,which was lower than that of national normal model(1.78±0.52)points,and the negative coping style score was(1.15±0.58)points,which was lower than that of national normal model(1.59±0.6)points,and the difference had statistical significance(P<0.001).(3)The total score of social support of the study subjects was(38.45±7.88)points,among which the score of subjective support was(23.16±5.08)points(national normal model 21.85±3.46 points),the score of objective support was(8.77±3.34)points(national normal model8.10±3.19 points),and the score of utilization of social support was(6.56±2.21)points(national normal model 7.82±1.80 points).The differences were statistically significant(P<0.05).(4)The results of correlation analysis showed that the total score of self-management was positively correlated with the score of active coping style(r=0.261,P<0.01).The total score of self-management was positive correlation with the total score of social support(r = 0.156,P<0.01).(5)Results of univariate analysis: age,family monthly income,duration of coronary heart disease,number of previous hospitalization for coronary heart disease,history of interventional therapy,history of long-term medication,the number of long-term medication and the number of comorbidities had statistical significance in the total score of self-management(P<0.05).There were statistically significant differencesin the scores of gender,age,family-month income,number of previous hospitalizations for coronary heart disease,history of long-term medication,and the number of long-term medication in daily life dimensions(P<0.05).There were statistically significant difference in the scores of gender,family-month income and number of previous hospitalization for coronary heart disease in the medical management dimension of disease(P<0.05).There was statistically significant difference in the score of emotional management dimension between the education level and number of previous hospitalizations for coronary heart disease(P < 0.05).(6)The results of multiple linear regression analysis showed that there were 5 factors including the duration of coronary heart disease,the number of long-term medication,family monthly income,the number of previous hospitalization for coronary heart disease and positive coping style entered the regression model.The regression model was analyzed by F test,F=14.416,P<0.01,The fitted multiple linear regression equation was statistically significant.Conclusions(1)The self-management level of patients with coronary heart disease in rural areas was lower and the level of medical management of diseases was the lowest.(2)The course of coronary heart disease,the number of long-term medication,family monthly income,the number of previous hospitalizations for coronary heart disease and the positive coping style were the main factors influencing the self-management of coronary heart disease in rural areas.