Effects Of Therapeutic Communication System On Uncertainty In Illness Of Patients With Percutaneous Coronary Intervention Treatment

Objectives The objective of this research was to describe uncertainty of patients who received percutaneous coronary intervention and the influencing factors,and to explore the relationship between uncertainty in illness,the quality of life and health related behavior. The other objective was to evaluate the change of uncertainty of patients who received percutaneous coronary intervention,when the therapeutic communication system was used.Methods During July 2013 and July 2014,We chose the patients with coronary heart disease who were ready to receive percutaneous coronary intervention with the method of convenience sampling. When they were ready to do PCI,researchers tell them to write MUIS-A,SF-36,Health related behavior scale and the demographic form,try to describe the demographic characteristics、uncertainty in illness、life quality and health related behavior,and the relationship between uncertainty in illness、life quality and health related behavior. If they were willing to attend,the researcher divided them into experimental and control groups according to the ward. Ordinary communication was used to the control group,and therapeutic communication system was used to the experimental group. The MUSI-A were evaluated at the day they would leave hospital. At last,66 patients finished the experiment,35 were as control group,31 were as experiment group. Three months after patients left hospital,the SF-36 and Health related behavior scale were conducted by telephone follow-up. At last,30 patients finished the experiment,15 was in control group,15 was in experiment group.Results ①The mean score of uncertainty in illness of patients who received PCI was 89.76±13.43,belong to the middle level. Among them,12.1% was belong to the low level,87.9% was belong to the middle level,and no patients at the high level.The score of the dimension of ambiguity,the dimension of lacking information,the dimension of complexity,the dimension of unpredictability from high to low in turn.②The total score of the uncertainty in illness as dependent variable,the family income,the dimension of social function、general health and coping with stress as independent variables,and then through multiple linear regression,family income and cope with stress into the regression model of uncertainty in illness,and the two factors explained 42.2% of the variation.③The total score of uncertainty in patients with coronary heart disease who received PCI and the dimension of coping stress had low negative correlation(r=-0.331,P<0.01).The dimension of coping stress and the dimension of ambiguity had low negative correlation(r=-0.292,P<0.05),the dimension of complexity and the dimension of drug management had low negative correlation(r=-0.339,P<0.01),the dimension of unpredictable and the dimension of coping stress had low negative correlation(r=-0.307,P<0.05).④The total score of Uncertainty in patients with coronary heart disease who received PCI and the dimension of social functioning and the dimension of general health had low negative correlation(r=-0.259、-0.290,P<0.05). The dimension of ambiguity and the dimension of role emotional、the dimension of social functioning and the dimension of general health had low negative correlation(r=-0.257、-0.378、-0.312,P<0.05),the dimension of ambiguity and the total score of the quality of life,and the dimension of mental health had low negative correlation(r=-0.374、-0.327,P<0.01). The dimension of unpredictable and the dimension of mental health and the dimension of general health had low negative correlation(P<0.05).⑤Before the intervention,there had no significant difference between total score of MUSI-A and four factors as well as SF-36 and health related behavior scores(P>0.05)between the two groups.After the intervention,the level of uncertainty in illness of the is lower than the control group,and the quality of life of patients in the experimental group was improved,they adopted a healthier lifestyle,all the differences were statistically significant(P<0.05).Conclusions ①Nurses should pay more attention to uncertainty of patients who received percutaneous coronary intervention,especially the patients who had lower family income,and they should give targeted nursing intervention to help people establish healthy beliefs and opinions.②TCS could help patients who received percutaneous coronary intervention effectively control disease uncertainty,improve the quality of life,and establish health behavior.