Study On Influencing Factors Of Self-management Behavior Of Elderly Patients With Chronic Diseases Based On Stress System Theory

Purpose:To investigate the status quo of stress perception,social relationship quality,patient activation,self-compassion and self-management behavior of elderly chronic disease patients in Yanji city.To analyze the relationship between self-management behavior and stress perception,social relationship quality,patient activation and self-compassion,of elderly chronic disease patients.In order to provide scientific theoretical basis for early evaluation and comprehensive intervention of self-management behavior in elderly chronic disease patients,the mechanism of self-management behavior among influencing factors was discussed by constructing structural equation model.Methods: Through convenient sampling,a total of 315 elderly patients with chronic diseases were selected from March to July 2021 in a third-class general hospital in Yanji,a community health service center and a physical examination.Investigated with stress perception scale,social relations quality scale,positive scale,self-care scale and self-management behavior scale for elderly patients with chronic diseases.SPSS26.0and AMOS24.0 are used for data analysis and processing.Results:(1)General information of research objects: The average age of the 315 subjects was 69.13±6.19 years old.There were 140 males(44.4%)and 175 females(55.6%).About half(50.2%)were Ethnic Koreans,135(42.9%)had high school education or above,and most(82.2%)were married.Most of the subjects lived with their spouse(73.3%),136 subjects(43.2%)enjoyed employee medical insurance,and more than half(71.4%)suffered from two or more chronic diseases.(2)The status quo of the subjects’ stress perception,quality of social relations,patient activation,self-compassion and self-management behavior.The stress perception score was 21.38±9.39,and most of the patients were at a high stress level(74.6%).The score of social relationship quality was 48.98±5.27,and the score of friend relationship dimension was the lowest.The patient activation score of the patients was 51.71±10.45,which was at the second level overall,that is,the patients had been conscious to be responsible for their own health,but lacked the knowledge and confidence to take action;The score of self-compassion was 70.33±9.87,and the score of self-tolerance was the highest.The score of self-management was 70.33±9.87,which was in the middle level,and the score of eating habits was 16.50±2.62.(3)The single factor analysis showed: gender,age,level of education,at present the family residence,marital status,living conditions,monthly family income,medical insurance,fixed number of year of the chronic diseases diagnosis,nearly a year due to the number of chronic diseases in the hospital,perceived stress,self care,quality of social relations,positive degree of influence of self-management of behavior(P <0.05).(4)Pearson correlation analysis showed that self-management behavior was negatively correlated with stress perception(r = 0.647,p < 0.01),positively correlated with social relationship quality(r = 0.683,p < 0.01),positively correlated with patient activation degree(r = 0.667,p < 0.01),and positively correlated with self-compassion(r = 0.575,p < 0.01).(5)The multiple linear regression results showed that a total of 10 variables into the regression equation,including p stress perception,level of education,patient activation,fixed number of year of the quality of social relations,self-compassion,chronic disease diagnosis,monthly family income,urban and rural residents medical treatment insurance,gender,age,which were explained 71.8% of the total variation of self management behavior research object。(6)The structural equation model shows that stress perception can directly negatively predict self-management behavior,and the direct effect is-0.267;the social relations quality can directly predict self-management behavior positively,with a direct effect value of 0.568;patient activation can directly predict self-management behavior positively,with a direct effect value of 0.168;self-Compassion can directly predict self-management behavior positively,with a direct effect value of 0.154.Stress perception can also act on self-management behavior through the single intermediary of social relationship quality,accumulated extreme,self-care and the chain intermediary of social relationship quality-self-care,positive-self-care,social relationship quality-cumulative extreme-self-care,and the indirect effect value is-0.411.Conclusions:(1)The self-management behavior of elderly chronic disease patients in Yanji is at a medium level and needs to be further improved.More attention should be paid to men,young people,people with low education levels,poor monthly family income,people with urban and rural health insurance and people newly diagnosed with chronic diseases.(2)The lower the stress perception,the better the quality of social relations,the higher the patient activation,and the higher the self-compassion,the better the self-management behavior of the elderly chronic diseases patients.(3)Stress perception,social relationship quality and patient activation can affect self-management behavior directly and indirectly,and self-compassion can directly affect self-management behavior and play an important role as intermediary variables.among them.The indirect effect of stress perception is the greatest,and the total effect and direct effect of the quality of social relations is the greatest.