Association Of Uncertainty In Illness With Anxiety And Family Support In Elderly Patients After A Percutaneous Coronary Intervention In Coronary Care Units

[Objectives]The purpose of this research was to investigate the current situation of uncertainty in illness among elderly patients with percutaneous coronary intervention(PCI)in coronary care units(CCU),and to know the influencing factors of uncertainty in illness,and to analyze the correlation of uncertainty in illness with anxiety and family support in order to provide empirical evidence for developing nursing interventions to reduce uncertainty in illness of elderly patients with PCI.[Methods]155 elderly patients with PCI in CCU were surveyed in 2 first-class hospitals in Jinan city from November 2018 to January 2019 by using a convenient sampling method with a general questionnaire,the Mishel Uncertainty in Illness Scale for Adult(MUIS-A),State Anxiety Scale,and Family Support Scale.Of the 155 surveys distributed,150 valid ones were collected for a response rate of 97%.The data was analyzed with SPSS 22.0 software and the level of significance was set at p<0.05.[Results]1.The total score of UIS in elderly patients with PCI in CCU was 67.64±8.72(58.4～91.7),which was at a medium level of uncertainty.The score on the ambiguity dimension of UIS was 43.26±5.35,and the average of items on the ambiguity dimension was 3.84(>3.67),reflecting a high degree of ambiguity.The score on the complexity dimension of UIS was 24.38±3.37,and the average of items on the complexity dimension was 2.53(2.33～3.66),which reflected a medium level.2.Results by one way analysis showed there were statistical significance in total score of UIS with different age(p=0.013),marital status(p=0.012),occupation(n=0.031),educational level(p=0.021),monthly income(p=0.017),medical payment method(p=0.012),course of illness(p=0.017),and previous history of a PCI(p=0.009)among elderly patients with PCI in CCU.There were statistical significance in ambiguity dimension of UIS with different age(p=0.041),gender(p=0.021),marital status(p=0.014),educational level(p=0.026),monthly income(p=0.012),and course of illness(p=0.041).And there were statistical significance in complexity dimension of UIS with different age(p=0.021),marital status(p=0.030),monthly income(p=0.032),and medical payment method(p=0.032).3.The mean postoperative anxiety score of the elderly patients with PCI in CCU was 43.37±1.36,which was higher than that of national norm(39.91).Significant positive correlations were found between state anxiety and levels of uncertainty in illness,ambiguity dimensions and complexity dimensions(r=0.469,0.372,0.410,all ps<0.01).4.The mean level of family support score of the elderly patients with PCI in CCU was 8.26±1.53,which had a moderate level.Significant negative correlations were found between family support and levels of illness uncertainty,ambiguity dimension,and complexity dimension(r=-0.502,-0.438,-0.367,all ps<0.01).5.The results of multiple linear regression analysis suggested that monthly income(p<0.001),age(p=0.034),course of illness(p=0.002),and history of a previous PCI(p=0.004)were influencing factors of UIS among elderly patients with PCI in CCU.Monthly income(p<0.001),marital status(p=0.024),and educational level(p=0.012)were influencing factors of ambiguity dimension.Age(p=0.034),marital status(p=0.001),monthly income(p<0.001)and state anxiety(p=0.002)were influen-cing factors of complexity dimension of UIS among elderly patients with PCI in CCU.[Conclusion]1.A medium level of illness uncertainty was found in elderly patients after undergoing a PCI in CCU.Their mean score on the ambiguity dimension of the UIS was high,and their mean score was moderate on the complexity dimension.2.The level of state anxiety in the elderly patients with PCI in CCU was higher than that of national norm,and their level of family support was at the moderate level.The level of uncertainty in illness and its two dimensions were positively correlated with state anxiety and negatively correlated with family support.3.Monthly income was a significant predictor of patients’ illness uncertainty and its ambiguity and complexity dimensions.Age,course of illness,and previous history of a PCI were significant predictors of the level of illness uncertainty in the patients with PCI.Marital status and educational level were significant predictors of scores on the ambiguity dimension of disease uncertainty,and age,marital status and state anxiety were significant predictors of scores on the complexity dimension of disease uncertainty.