A Comparative And Risk Factors Study Of Quality Of Life General Self-efficacy And Self-acceptance In Patients With Adult Cardiac Disease Afer Surgical Treatment

Objectives In this study,we compare the activity of daily life,postoperative pain, postoperative incision pain syndrome,quality of life,general self-efficacy, self-acceptance of congenital heart disease by total thoracoscope and median sternotomy. To explore the effect of quality of life,general self-efficacy and self-acceptance of patients with congenital heart disease after operation.Methods Subjects were selected from a convenience sample that patients with congenital heart disease after operation.during September in2011to September in2012in a level of first-class hospital.The study were conducted the questionnaire survey by interview and telephone interview.The questionnaire were filled by the investigator according to answers of the subjects. The questionnaires included six parts:the general information questionnaire,the ability of daily life scale(ADL)(Barthel index). Numerical Pain Rating Scale(NPRS).Item Short Form Health Survey (SF-36), general self-efficacy scale,self-acceptance scale.The pain was evaluated in three days afer operation;the ability of daily life was evaluated in seven days afer operation and the postoperative incision pain syndrome.the quality of life.general self-efficacy and self-acceptance was assessed in three months afer operation. Using SPSS17.0statistical software for data entry and analysis, including descriptive analysis, nonparametric test-rank sum test(Mann-Whitney U test for comparison between two groups),Chi-square test,Fishers exact test, one-way analysis of variance and multiple linear stepwise regression analysis. Results A total of208patients were investigated by telephone interview and168(80.76%)effective questionnaire have been got. Detailed information was as follows:1. Mind dependence in TTS group is84.4%;while heavy dependence is71.4%in MS group.The scores of operative pain was1.59+0.62for TTS group,2.83±0.38for MS group.all of which were statistical significance.2. According to the results of Mann-Whitney U test,the scores of all dimensions of quality of life for TTS group were higher than the MS group,The scores of general self-efficacy for TTS and MS group were3.46±0.36、2.47±0.44,respectively;The scores of self-acceptance were43.41±2.49,35.19±3.11,respectively.all of which was significant between TTS and MS group.3. One way ANOVA of proposal influence factors for quality of life after three months operation:The risk factors were:older patients(age from45to60),junior middle school and primary school, cardiac function Ⅱ level,MS and PTPS. Multiple linear regression analysis for SF-36showed that：operation method,cardiac function and PTPS were precdictive factors of SF-36,which explained65.7%of total variance.4. Oen way ANOVA of proposal influence factors for general self-efficacy(GSE) after three months operation:The risk factors were:older patients(age from45to60),living alone, junior middle school and primary school, cardiac function Ⅱ level,MS and PTPS. Multiple linear regression analysis for GSE showed that:operation method,cardiac function,SF-36and PTPS were precdictive factors of GSE,which explained66.9%of total variance.5. One way ANOVA of proposal influence factors for self-acceptance(SA) after three months operation:The risk factors were:female,youger patients(age from18to35),MS,cardiac function and PTPS. Multiple linear regression analysis for SA showed thatOperation method was the only predictive factor of SA,which explained52.7%of total variance.Conclusion1. Compared to the MS group,the patients with CHD of TTS group have better ability of daily life,lighter pain afer operation.2. The patients with CHD of TTS group have a better quality of life,GSE and SA than whom of MS group after operation.3. The risk factors which influence the quality of life of the patients with CHD are:older patients(age from45to60),junior middle school and primary school, cardiac function Ⅱ level,MS and PTPS:operation method,cardiac function and PTPS are precdictive factors of quality of life.so we should pay more attention to the older patients with low level education,cadiac function Ⅱ level.MS and PTPS.4. GSE is influenced by rick factors:older patients(age from45to60),living alone, junior middle school and primary school, cardiac function Ⅱ level,MS and PTPS. operation method,cardiac function,quality of life and PTPS were precdictive factors of GSE.medical personnel should attach more importance to high-risk patients of cardiac function level, illiteracy, older, living alone,PTPS and MS.5. The risk factors which influence self-acceptance of the patients with CHD are female,youger patients(age from18to35),MS,cardiac function and PTPS.Operation method is the predictive factor of self-acceptance.nurses should pay more attention to the female,youger patients(age from18to35),MS.cardiac function and PTPS.