Effect Of Uncertainty In Illness On Quality Of Life Of Patients With Acute Ischemic Stroke And Mediating Effect Analysis

BackgroundAcute ischemic stroke is the most common type of stroke.Because patients are not clear about the treatment and prognosis of the disease,it is easy to feel uncertain about the disease.This kind of disease experience will hinder the patient’s confidence in recovery and affect their quality of life.Quality of life is an evaluation index of physical and mental health and social adaptation of patients after stroke.Studies have confirmed that disease uncertainty affects the quality of life of individuals,but it is still unclear whether the relationship between the two is still affected by other factors.ObjectiveTo investigate the status of uncertainty in illness and its influencing factors in patients with acute ischemic stroke.To construct mediating effect model.Aim to provides a certain theoretical basis for clinical development of targeted intervention measures.Method1.From June 2019 to December 2020,patients with acute ischemic stroke in the neurology department department of 5 tertiary A hospitals in Henan Province were selected as the research objects.By the self-developed general data questionnaire and National Institutes of Health Stroke Scale（NIHSS）,Modified Rankin Rating Scale（m RS）,Social Support Scale（SSRS）,Medical Coping Style Questionnaire（MCMQ）,Illness Uncertainty Scale（MUIS-A）,Hospital Anxiety and Depression Scale（HADS）,Stroke Special Quality of Life Scale（SS-Qo L）to conduct a questionnaire survey.2.Statistical analysis was performed using SPSS 26.0 and AMOS 22.0 software.The count data was described by frequency and composition ratio,and the measurement data was expressed by mean and standard deviation.The t-test and analysis of variance were used to perform single factor analysis of patients’uncertainty.Pearson correlation was used to analyze the relationship between NIHSS,m RS,SSRS,MCMQ,HADS,SS-Qo L,and MUIS-A.3.Set the statistically significant ones in univariate analysis and correlation analysis as independent variables,and perform multiple linear regression analysis on uncertainty.Use path analysis to explore the path of the impact of uncertainty on the quality of life in patients with acute ischemic stroke relationship.Results1.The total score of uncertainty in patients with acute ischemic stroke was（75.21±10.41）,which was at a moderate level.A total of 48.2%and 51.8%of patients were in low and above average level.Age,education level,caregiver,monthly income,payment method of medical expenses,number of strokes,smoking history,drinking history,m RS,submission,subjective support,utilization of support,social role were the influencing factor of illness uncertainty in patients with acute ischemic stroke,which can account for42.00%of the variation of illness uncertainty（adjusted R²=0.420,F=1.923,P=0.039）.2.The patients had moderate uncertainty,social support,medical coping styles,and quality of life and anxiety,depression are mild in the acute ischemic stroke.Uncertainty was positively correlated with NIHSS,m RS,medical coping style,anxiety and depression(r_NIHSS=0.076,r _{m RS}=0.016,r_MCMQ=0.195,P<0.05;r_HADS=0.175,P<0.01),and was negatively related to social support and quality of life(r_SSRS=-0.204,r_{SS-Qo L}=-0.241,P<0.01).3.The results of mediating effect analysis show that uncertainty in illness can not only directly affect the quality of life,but also indirectly through medical coping styles,anxiety and depression.Medical oping style played the strongest mediating role between illness uncertainty and quality of life,at 51.72%,followed by the mediating role of anxiety and depression between illness uncertainty and quality of life,at 12.50%,and finally coping style and depression The mediating effect between disease uncertainty and quality of life was 6.67%,and this path has the weakest effect.ConclusionThe quality of life of patients with acute ischemic stroke is at a moderate level and needs to be improved.Uncertainty not only directly affect the quality of life,but also indirectly through the mediating effects role of anxiety,depression and medical coping style.