| BACKGROUNDCoronary atherosclerotic heart disease (CHD) has become one of the leading global causes of death now. Statistics of the United States institute of cardiology show that CHD accounts for 1/3 to 1/2 of the total dead population of the United States, and accounts for 1/2 to 3/4 of the total number of heart disease death. At present, It has reported at least two hundred and ninety million patients with cardiovascular diseases in our country, and about 3.5 million people die each year from cardiovascular disease. The number of deaths accounted for the first of each disease. The medical cost of patients with coronary heart disease has become a heavy burden of medical resources. To strengthen the mastery of disease relevant knowledge for patients with coronary heart disease can improve the patient’s compliance with life and drug treatment.For coronary heart disease patients, because of the long course of disease, recurrent disease, hospitalized several times, without sufficient knowledge of diseases and the treatment experience, unaware of the disease occurrence, development, and the disease severity and nursing, more over unknowing of the treatment effect and the prognosis of the disease, which will induce a sense of uncertainty in illness.Many factors can affect the disease uncertainty, such as gender, age, culture level, course of the disease, degree of disease related knowledge mastery, and so on. The illness uncertainty is also affected by the patient’s cognitive abilities and the help given. There is a close relationship between illness uncertainty and anxiety, depression and frustration, and the level of illness uncertainty can affect patients’ coping styles, and then resulting in impact on the patient’s disease rehabilitation and quality of life. Therefore, it is necessary to understand the current situation of disease uncertainty in hospitalized patients with coronary heart disease and to explore influencing factors of illness uncertainty of hospitalized patients with coronary heart disease, and investigate the level of uncertainty of hospitalized coronary heart disease patients, and analysis the relationship between uncertainty in hospitalized patients with coronary heart disease and coronary heart disease knowledge master and social support. And then we can provide targeted nursing measures for patients, finally it will reduce the recurrence rate of patients with coronary heart disease and the uncertainty of illness in hospitalized patients with coronary heart disease.OBJECTIVESCoronary heart disease incidence rate is high, and the mortality rate is high. These patients in hospital have to receive complicated treatment and nursing care. Most patients lack medical knowledge and don’t know how to control risk factors. Because of lack the coping measures during the attack, they will have psychological problems such as anxiety and depression, resulting in a disease uncertainty. The present study is to investigate the status of disease uncertainty of hospitalized patients with coronary heart disease and to know the degree of knowledge about coronary heart disease and coronary heart disease in patients with coronary heart disease, and to explore the relationship between the illness uncertainty of hospitalized coronary heart disease patients and the knowledge of coronary heart disease, and the relationship between the social support and the related knowledge.METHODSA cross-sectional study via convenience sampling was carried out in our study. The time is from May 2015 to December 2015. Coronary heart disease patients were selected in the first affiliated hospital of Bengbu medical college, Anhui Province. The questionnaire includes the basic situation of the questionnaire designed by ourselves, and Xiao Meilian’s coronary heart disease related knowledge assessment questionnaire, Mishel’s disease uncertainty scale, Xiao Shuiyuan’s social support scale. All data using Epidata3.1 software were to establish database and computer access to patient date entry and statistical analysis using SPSS 18.0 software. The statistical description of the survey results are in the form of mean ± standard deviation, t test, variance analysis and Pearson correlation analysis method were carried out among groups. P< 0.05 was considered as the significant difference.MAIN RESULTS(1) The total score of illness uncertainty score between 34-133 scores for coronary heart disease patients with an average scores (85.63± 18.06), overall at the medium level. we found that unclear dimension scores were the highest. Coronary heart disease related knowledge scores were (28.52±12.90), the secondary prevention knowledge scores were highest. Social support scores were (38.33 ± 8.38), is higher than domestic normal (34.56±3.73), and the difference was statistically significant (P <0.05).(2) Univariate factor analysis of knowledge score of coronary heart disease: different gender,the influence of different educational level, economic income, with or without family history on health related knowledge difference was statistically significant. The complexity of disease uncertainty was negatively correlated with the 8 dimensions of coronary heart disease knowledge. The lack of information dimension was positively correlated with the specialist examination in coronary heart disease. The unpredictable dimension and the drug knowledge dimension of coronary heart disease were negatively correlated. Among them, differences among different knowledge score and coronary heart disease uncertainty dimension of complexity and unpredictability dimension were statistically significant; there were significant differences in the different types of coronary heart diseases, different age groups, different smoking status and the complexity of uncertainty. There was significant difference between the different medical insurance payment methods and the uncertainty dimension of illness uncertainty. Multiple regression analysis showed that:payment of medical expenses is a significant factor in patients hospitalized with coronary heart disease sample hospitals of uncertainty.CONCLUSIONS AND SUGGESTIONSThe disease uncertainty of hospitalized coronary heart disease patients was in the medium level. The main factors that affect the illness uncertainty of patients are: score of different knowledge of coronary heart disease, different age stages, different types of coronary heart disease, and different types of medical insurance payment, smoking status. We also found that social support had an impact on the level of disease uncertainty. With the degree of social support greater, the level of disease uncertainty in patients was lower. Therefore, our results of the study to remind the medical staff in the work to assess and analyze the level of disease uncertainty vary from person to person, especially for the different cultural degree, different ages stages, poor economic conditions and bad health behavior of patients with coronary heart disease, we should have more communication with patients to explain the professional knowledge to give psychological counseling, and enhance the patient’s confidence in the treatment of disease, to provide professional information support, reducing the patient’s disease uncertainty, finally improving the treatment effect and quality of life. |
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