Study On The Coping Style And Its Related Factors In Middle Aged And Elderly Patients With Coronary Heart Disease In Fuzhou

Objective:1 To investigate the coping style, social support, personality, self-esteem and interpersonaltrust in the middle aged and elderly patients with coronary heart disease (CHD).2 To evaluate the relationship between coping style and demography, sociology and disease,social support, personality, self-esteem and interpersonal trust in the middle aged and elderlypatients with CHD.3 To develop nursing interventions for improving patients to take active coping style.Methods:The study was carried out in a community and 5 hospitals in Fuzhou, Fujian. 284 middleaged and elderly patients with CHD were assessed with MCMQ(Medical Coping ModesQuestionnaire), SSRS(Social Support Rating Scale), EPQ(Eysenck PersonalityQuestionnaire-Adult), SES (Self-Esteem Scale), ITS(Interpersonal Trust Scale) and thequestionnaire about data of demography, sociology and disease. All data were statisticallyanalyzed.Results:1 In contrast with the ordinary mode, the score of "confrontation"coping style wassignificantly lower and the score of the "avoidance"coping style was significantly higher inthe middle aged and elderly patients with CHD. The patients got more social support than theordinary mode, but that were great differences in the different patients. Family membersbecame the main resource of social support in the patients. The distribution of the patients'introversion-extroversion (E) was middle (45.8%), extroversion (22.2%),tend-extroversion(14.4%), introversion (9.5%), and tend-introversion(8.1). The distribution ofthe patients'stability of emotion(N) was middle(44.4), tend-instability of emotion(19.7%),stability of emotion(16.5%), tend-stability of emotion(10.9) and instability of emotion(8.5).The distribution of temperament type was the sanguineous(22.2%), the bilious(19.4), thedumps(16.5), the phlegm(14.8%), and the unclassification(27.1). The middle-aged patientshad higher N and P score than the elderly patients. The female patients had higher score ofself-esteem than the male patients. The score of interpersonal trust in the patients was lowerthan the middle score.2 The "confrontation"coping style is significantly positive correlation to subjective socialsupport(X21; Standardized Coefficientsβ'=0.348), utility of social support (X22;β'=0.399),self-esteem(X27 ; β'=0.240) and interpersonal trust(X28 ; β'=0.366), and that issignificantly negative correlation to sex(X1;evaluation:female=1,male=2;β'=0.239) and therelationship of family (X11;evaluation:good=1,commonly=2,bad=3;β'=0.335);The regressionequation:Y1 =19.734–1.858X1–2.029X11+0.302X21 +0.800X22 +0.349X27 +0.147X28 (F=14.161,P=0.000,R2=0.684)。 The "avoidance"coping style is significantly positive correlation tointroversion-extroversion (X23;β'=0.387),and that is significantly negative correlation tocharacteristic of profession(X4;evaluation:physical work=1,brainwork=2;β'=0.227), patients(X7;evaluation:patients in home=1,patients in hospital=2;β'=0.268), income(X8;evaluation:<$1000=1,>$1000=2;β'=0.345) and objective social support(X20;β'=0.424); The regression equation:Y2 =15.132–01.202X4–1.380X7 –1.929X8-0.341X20 +0.196X23 (F=6.831,P=0.000,R2=0.591)。 The "compromising"coping style was significantly positive correlation to old(X2;evaluation:middle aged=1,young elderly=2,old elderly=3;β'=0.320), life style(X13;evaluation:lived with family=1,lived alone or only with spouse=2;β'=0.168), heart function(X18;evaluation:I grade=1,II grade=2,III grade=3;β'=0.160) and neurotism (X24;β'=0.332, and that issignificantly negative correlation to profession(X4;evaluation:physical work=1,brainwork=2;β'=0.299), fee-for-service (X9;evaluation: one's own expenses=1,part public expense =2,complete public expense=3;β'=0.173), objective social support (X20;β'=0.232), subjectivesocial support (X21;β'=0.325), self-esteem(X27;β'=0.289) and interpersonal trust(X28;β'=0.233);The regression equation:Y3=13.839 +2.928X2 –2.041X4 –0.819X9 +1.046X13+0.609X18 -0.240X20 –0.231X21 +0.175X24 –0.344X27 –0.076X28(F=13.082,P=0.000,R2=0.724)。Conclusion:1 The middle aged and elderly patients took more "avoidance"coping style and less"confrontation"coping style.2 The main related factors of "confrontation"coping style (according to score of β'inorder)were utility of social support, subjective social support, interpersonal trust, therelationship of family, self-esteem and sex. The main related factors of "avoidance"coping style (according to score of β'inorder)were objective social support, introversion-extroversion, income, patients in home or inhospital, and characteristic of profession. The main related factors of "compromising"coping style(according to score ofβ'inorder) were neurotism, subjective social support, old, profession, self-esteem, interpersonaltrust, objective social support, fee-for-service, life style, and heart function.3 It is important for nurses in hospitals and communities to know which coping style thepatients took. Nurse can take some nursing interventions to promote the patients to take activecoping style according to the related factors.