| ObjectiveTo understand the current status of self-efficacy,coping style,quality of life,and mental health in patients with Diabetic Retinopathy(DR);To explore the relationship between these three factors and mental health,construct a path model among them;To reveal the comprehensive mechanism of influencing factors on mental health of DR patients;To provide theoretical guidance for psychological nursing of DR patients,and effectively promote the standardized management of chronic diseases.MethodsDR patients hospitalized in the people’s Hospital of Ningxia Hui Autonomous Region from November 2019 to November 2020 were selected as the research objects for questionnaire survey.The Self-made general information questionnaire,Symptom check list-90(SCL-90),Scale of Life Quality for Diseases with Visual Impairment(VQOL-DVI),General self-efficacy scale(GSES)and Medical Coping Style Questionnaire(MCMQ)were used for the survey 354 questionnaires were collected.All the data collected from the questionnaire were used to establish a database by Excel software,and SPSS 25.0 and AMOS24.0 statistical software packages were used for data analysis.The measurement data were described by means and standard deviation,and the comparison between groups was performed by t-test and analysis of variance;the counting data utilization rate and constituent ratio were described;Pearson correlation analysis was used to study the correlation among mental health,visual impairment,quality of life,coping style and self-efficacy of DR patients;according to the visual impairment,quality of life,coping style,self-efficacy and self-efficacy of DR patients in the early stage The path model was analyzed by AMOS 24.0,and the maximum likelihood method was used to estimate the parameters.Results(1)A total of 374 questionnaires were distributed and 354 valid questionnaires were collected.According to the demographic and sociological data,the average age of the included samples was 56.90±9.44 years old,with female patients in the majority(55.6%);proliferative DR accounted for the majority(66.9%);patients with disease course more than half a year accounted for 57.9% of the total number.(2)The total score of mental health of DR patients was 137.62±37.59,and the top three factors from high to low were depression,compulsion and hostility;the detection rate of psychological problems was 44.63%,and the top three factors from high to low were depression,somatization and interpersonal sensitivity.Univariate analysis of general data on the mental health of DR patients showed that gender,age,education level,marital status,occupation,family location,monthly average income,whether drinking alcohol,hypoglycemic drug use,course of disease,lesion type,visual acuity classification and intraocular pressure had differences in the total score of mental health of DR patients(P<0.05).Multiple linear regression analysis showed that age,occupation,course of disease,visual acuity grade and whether drinking alcohol entered the regression equation could explain the 18.4% variation of the total mental health score of DR patients.(3)The results of quality of life of DR patients showed that: the score of quality of life of DR patients was 77.22±34.06,and the quality of life of DR patients was generally low;there were significant differences in the quality of life and each dimension score of DR patients with different lesion types(P<0.05);the quality of life of DR patients was negatively correlated with the total score of mental health and each dimension score,and the difference was statistically significant(P<0.05).(4)The results of coping style of DR patients showed that there were statistical differences in coping styles of DR patients with different types of retinopathy(P<0.05);the scores of coping styles of DR patients were negatively correlated with the total score of mental health,and the scores of avoidance and yield coping styles were positively 1correlated with the total scores of mental health(P<0.05).(5)The results of self-efficacy of DR patients showed that: there were statistical differences in the scores of self-efficacy of DR patients with different types of retinopathy(P<0.05);the self-efficacy of DR patients was negatively correlated with the total score of mental health and the scores of each dimension,and the differences were statistically significant(P<0.05).(6)The results showed that quality of life had a direct negative effect on mental health(β=-0.238,P< 0.001);self-efficacy had a direct negative effect on mental health(β=-0.111,P=0.043);avoidance coping style had a direct positive effect on mental health(β=0.110,P=0.025);yielding coping style had a direct positive effect on mental health(β=0.280,P<0.001);yielding coping style had a direct positive effect on mental health(β=0.280,P<0.001)There was a direct negative effect on quality of life(β=-0.320,P<0.001),and a negative effect on self-efficacy(β=-0.400,P<0.001).Conclusion(1)The mental health status of DR patients is poor.The main factors leading to the poor mental health status of DR patients are age,occupation,course of retinopathy,visual acuity classification and drinking.(2)The quality of life of DR patients is generally low,the general self-efficacy is in the middle level,and the patients are more inclined to face the disease with a yielding coping style.(3)Visual function impairment and quality of life directly or indirectly affects mental health through general self-efficacy and medical coping style.General self-efficacy and medical coping style affect mental health of patients as both direct and intermediate variables.Therefore,in the psychological nursing of DR patients,the subjective cognition or feelings of patients can be used as the main predictor of mental health,and other objective environment,pathophysiology and other conditions can be used as secondary predictors.Nurses need to do what they can to improve the psychological health of patients by improving their quality of life,self-efficacy and coping style. |
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