Study On The Status Of Illness Perception And The Construction Of Intervention Program In Patients With Non-proliferative Diabetic Retinopathy

Objectives1.To investigate the status of illness perception in patients with non-proliferative diabetic retinopathy and to analyze the influencing factors.2.To construct an intervention program of illness perception for patients with non-proliferative diabetic retinopathy based on the self-regulation theory.Method1.Current situation survey:From February 2020 to September 2020,patients with non-proliferative diabetic retinopathy in the ophthalmology and endocrinology department of two grade III a hospitals in jinan were selected for a cross-sectional survey.Data were collected included demographic characteristics,the brief illness perception questionnaire,diabetic retinopathy prevention knowledge questionnaire,medical coping modes questionnaire,social support rating scale.The SPSS 21.0 software was used for statistical analysis of data.Specific methods included descriptive statistics,one-way ANOVA,T test,Spearman correlation analysis,and multiple linear regression analysis.2.Intervention program construction:Combined with the results of cross-sectional survey and literature research,established a preliminary intervention program of illness perception for patients with non-proliferative diabetic retinopathy.Using Delphi expert consultation method,the final intervention program of illness perception for patients with non-proliferative diabetic retinopathy was established after two rounds of expert consultation.Results1.Current situation survey(1)A total of 200 questionnaires were issued in this study,of which 195were valid,with an effective rate of 97.5%.(2)The score of non-proliferative diabetic retinopathy patients’illness perception was(45.99±10.10),the disease care degree score was the highest(9.16±1.64),and the treatment control score was the lowest(2.62±1.68).(3)Univariate analysis showed that the level of illness perception in patients with non-proliferative diabetic retinopathy was statistically significant in terms of age,education,occupation,family income per capita,diabetes mellitus course,non-proliferative diabetic retinopathy severity,visual acuity and number of chronic disease(P<0.01,P<0.05).(4)Correlation analysis results showed that there was a significant negative correlation between the level of diabetic retinopathy prevention knowledge and the level of illness perception(r=-0.542,P<0.01),avoidance was negatively correlated with illness perception(r=-0.240,P<0.01),yield was positively correlated with illness perception(r=0.766,P<0.01).Subjective support and objective support were negatively correlated with illness perception(r=-0.666,-0.260,P<0.01).(5)Multiple linear regression analysis showed that non-proliferative diabetic retinopathy severity,visual acuity,number of chronic disease,diabetic retinopathy prevention knowledge,yield,and objective support entered the regression equation.The regression model fits well(R~2=0.792,F=57.930,P=0.000).According to the size of the standardized coefficient,the degree of impact on illness perception in order of non-proliferative diabetic retinopathy severity,visual acuity,yield,diabetic retinopathy prevention knowledge,objective support,number of chronic disease.2.Intervention program constructionIn this study,a total of 20 experts participated in the expert consultation,including 8 endocrinology specialists,9 ophthalmology specialists and 3 psychologists.In the two rounds of expert consultations,22 and 20 questionnaires were issued respectively,20 and 20 questionnaires were recovered respectively,and the effective questionnaire recovery rates were 90.9%and 100%respectively.The authority coefficient of the experts was all greater than 0.80.The Kendall coordination coefficients of the importance of the various parts were respectively 0.142,0.212 and 0.112(P<0.05)after two rounds of expert consultation.The final intervention program of illness perception for patients with non-proliferative diabetic retinopathy includes intervention program introduction(5 items),intervention theme(6 items)and intervention content(29 items),mainly from improving the knowledge level of prevention of diabetic retinopathy,correcting wrong cognition,improving negative emotion,guiding correct response,improving social support and encouraging self-regulation.Conclusion1.The illness perception of non-proliferative diabetic retinopathy patients in this study was at the middle level,non-proliferative diabetic retinopathy severity,visual acuity,number of chronic disease,diabetic retinopathy prevention knowledge,yield and objective support are the influencing factors of illness perception in non-proliferative diabetic retinopathy patients.2.Based on the self-regulation theory,combined with cross-sectional survey and literature research,an intervention program of illness perception for patients with non-proliferative diabetic retinopathy have been constructed.The results of two rounds of Delphi expert consultations are reliable.The intervention program has scientific and feasibility.It can be used for medical staff to intervene in patients with non-proliferative diabetic retinopathy to help patients reduce negative illness perception.