Study Of Characteristics Of Illness Behavior For Elderly Hospitalized Patients And Intervening Method

Objective:This study was conducted based on investigation of hospitalized elderly patients, to study the characteristics of their illness behavior and main influencing factors. Additionally, we try to find out valid intervening strategy and method to reduce the illness behavior through cognitive behavioral therapy.Methods:We collected data from two Departments of Geriatrics in two general hospitals. The subjects were mainly non-carcinomas stable patients, who can behave all by themselves. After explaining the objective of the study, we ask them to complete several questionnaires. And statistics methods included correlation analysis, t-test and multivariate analysis of variance. There were three parts in this research. Part1included137hospitalized elderly patients,67male and70female. They completed Illness Behavior Questionnaire (IBQ) and general condition investigation form after they were hospitalized. The correlations of different dimensions of illness behavior, and influencing effects of sex, age, whether the partner is still alive, education background, were analyzed. Additionally, the correlations of different illness behavior between out-patient pain patients and elderly hospitalized patients were analyzed,we try to find out the characteristics of hospitalized elderly patients’illness behavior. In part2, some of the subjects from part1completed Hospital Anxiety Depression Scale (HADS) and Perceived Social Support Scale (PSSS) to study the correlations between main psychological and social factors and illness behaviors. In part3, we designed main steps of cognitive behavioral therapy based on the results of the first two parts and principles of cognitive behavioral therapy. And we chose some of patients from subjects of part2to intervene, who completed IBQ and HADS again before they left hospital. And we validated the effects of intervene by comparing the changes of their anxiety and depression before and after the intervening.Results:We got the following results in this research.1. Three dimensions of illness behaviors (negative emotions, behavioral responses and role of being patients) of hospitalized elderly patients have significant correlations between each other.2. Elderly patients of different sexes have different severity of illness behavior. Female patients have more severe illness behavior in all three dimensions than male, and they need more attention and intervene.3. Elderly patients of different ages have different severity of illness behavior. Patients with ages of70-79have more severe negative emotions and role of being patients, than patients with ages of60-69and80or over.4. Whether the partner is still alive has significant effects on illness behavior of elderly patients. Elderly patients whose partner has passed away have more severe illness behaviors than patients whose partner is still alive, in all three dimensions.5. Elderly patients of different education background have different severity of illness behavior. Patients, who have collage or higher education, have more severe negative emotions and behavioral responses than patients with elementary or middle school education.6. Results of HADS show that elderly patients of different sexes have different proportions of anxiety and depression. Female patients have significant more proportion than male patients.7. Correlation study find that anxiety and depression have significant positive correlations with all three dimensions of illness behavior.8. After intervening some of the elderly patients, we find that for negative emotions, intervening and measuring time have significant main effects (Fi=79.3, p<0.001; Ft=5.9, p=0.02), and two variables have significant interaction (F=11.6, p=0.002). As for behavioral responses, only intervening has significant main effect (F=25.0, p<0.001). As for role of being patients, intervening has significant main effect (F=34.8, p<0.001), and intervening and measuring time have significant interaction (F=4.3, p=0.04).9. As for anxiety and depression, intervening have significant main effects (Fanxiety=16.7, p<0.001, Fdepression=4.8, p=0.04).Discussion:In this research, we use three consecutive studies to analyze characteristics of elderly hospitalized patients and the intervening methods. From the results, we could see that, patients with female sex, ages of70-79, losing partner, college or more education, have more severe illness behaviors. Anxiety and depression can aggravated with severity of illness behaviors, while perceived social support can reduce its severity to some extent. Cognitive behavioral intervening for elderly patients can reduce their illness behaviors and better their emotions. However, this research is just an exploration of the illness behavior. The number of subjects is relatively small, and the influencing factors analyzed are limited. All these problems need to be solved in the future, and provide reference for clinical diagnosis and treatments.