Study On The Association Of Perceived Control,coping Styles And Self-management Behaviors In Patients With Coronary Heart Disease

Objectives:By investigating the perceived control,coping styles and self-management behaviors of patients with coronary heart disease,to find the current status of perceived control,coping styles and self-management behaviors in patients with coronary heart disease;To explore the influencing factors of perceived control in patients with coronary heart disease;To analyze the correlation between perceived control,coping styles and self-management behaviors;To explore the influencing factors of self-management behaviors in patients with coronary heart disease;To provide effective evidence for improving the level of perceived control in patients with coronary heart disease,helping patients with coronary heart disease to choose an effective coping style,and promoting self-management behaviors of patients with coronary heart disease.Methods:230 inpatients with coronary heart disease in a third-grade class-A hospital in Changchun City were selected as research subjects by convenient sampling method and a questionnaire survey was conducted from June 2017 to November 2017.The questionnaires consist of a general information questionnaire,Control Attitudes Scale-Revised(CAS-R),Medical Coping Modes Questionnaire(MCMQ),and Coronary artery disease Self-management Scale(CSMS).The data was double-inputed using EpiData3.1,and SPSS23.0 statistical software was used for statistical analysis.The analysis methods include descriptive statistical analysis,t test,one-way analysis of variance,Pearson correlation analysis,multiple stepwise regression analysis,and so on.Results:1.The mean perceived control scores of patients with coronary heart disease were(26.16±5.95).The mean scores of each dimension of coping styles were as followed: confrontation(2.54±0.57),avoidance(2.11±0.40)and acceptance-resignation(1.75±0.58);the score of avoidance coping style was higher than the norm of domestic patients(P<0.001),and there was no significant difference between the score of confrontation coping style and the norm of domestic patients,the score of acceptance-resignation coping style and the norm of domestic patients.The total score of self-management behavior was(81.58±13.09),the score index was 60.43%;the scores of each dimension is sorted from high to low according to the score index: daily life management,emotional management,and disease medical management.2.Single-factor analysis showed that the factors affecting perceived control in patients with coronary heart disease include age,gender,marital status,education level,occupational status,living style,family average monthly income,type of coronary heart disease,duration of disease,and number of comorbidities;multiple stepwise regression analysis showed that living style,gender,age 60 to 70 years,junior high school,high school or secondary school,college and higher education level,retirement,and family average monthly income more than 5,000 yuan,myocardial infarction,disease duration more than 10 years,and number of complications more than 3 entered the regression equations,the above variables explain 37.7% of the total variation in perceived control.3.Single-factor analysis showed that the factors influencing the self-management behaviors of patients with coronary heart disease were age,marital status,education level,occupational status,residence,living style,family average monthly income;the result of multivariate stepwise regression analysis showed that living style,junior high school,high school or secondary school,college and higher education level,retirement,family average monthly income of 2000 to 5,000 yuan,family average monthly income more than 5,000 yuan entered the regression equation,the above variables account for 40.9% of the total variation in self-management behaviors.4.Correlation analysis showed that perceived control was positively correlated with confrontation(r = 0.349,P < 0.01),and negatively correlated with avoidance(r =-0.334,P < 0.01)and acceptance-resignation(r =-0.397,P < 0.01).Perceived control was positively correlated with self-management behaviors(r = 0.559,P < 0.01).Confrontation was positively correlated with self-management behaviors(r = 0.381,P < 0.01),avoidance(r =-0.431,P < 0.01)and acceptance-resignation(r =-0.482,P < 0.01)were negatively correlated with self-management behaviors.5.Hierarchical regression analysis showed that after controlling for the general demographic factors and the factors related to the disease and treatment of patients,perceived control,confrontation,avoidance,and acceptance-resignation were important influencing factors in patients' self-management behaviors.Conclusions:1.The perceived control and self-management behaviors of patients with coronary heart disease are at a moderately low level.Among the coping styles,the most frequently used coping styles of patients in order are confrontation,avoidance,and acceptance-resignation.2.The influencing factors of perceived control in patients with coronary heart disease mainly include: age,gender,education level,occupational status,living style,family average monthly income,type of coronary heart disease,duration of disease,number of complications.3.The influencing factors of self-management behaviors of patients with coronary heart disease mainly include: education level,occupation status,living style,family monthly income.4.perceived control and coping styles can affect the self-management behaviors of patients with coronary heart disease.The higher the level of perceived control,the higher the level of self-management behaviors;the higher the score of confrontation,the higher the level of self-management behavior,and the higher the avoidance and acceptance-resignation scores,the lower the level of self-management behaviors.