Investigation Of The Stages Of Self Painmanagement To Find Its Relation With The Quality Of Life In Patients With Coronary Heart Disease

ObjectiveBased on the stages of change model theory,to investigate the pain level,self management stages of pain and quality of life(QOL)in patients with coronary heart disease(CHD)and compare the differences of pain and QOL in each stages and also find out its related factors,in order to provide the basis for clinical intervention,reduce the pain level in patients with coronary heart disease and its influence on all aspects of life and improve the life quality of CHD patients.MethodsUsing convenient sampling method to select CHD patients at department of cardiology in a grade three first class hospital of Shandong Province,who conform to the sampling standard.Questionnaires include the self-design general information questionnaire,numerical rating scale(NRS),pain stages of change questionnaire(PCOCQ),Seattle angina questionnaire(SAQ).All data were analyzed by SPSS21.0 including descriptive analysis,variance analysis and Ordinal logistic regression model.Results1.168 out of 200 questionnaires were valid,the valid response rate was 84%,the mean age was 61.07±7.96 years,which including 96 males(57.1%)and 70 females(42.9%);urban residents(109,64.9%)were more than rural residents(59,35.1%);most patients were in a state of marriage(147,87.5%);in terms of education level,there were more patients with junior middle school education or below than others;in terms of economic income,most patients had a monthly income of 1000-5000 yuan.2.Distribution in each stage:49 people in precontemplation stage,66 in contemplation stage,35 in action stage and 18 in maintenance stage.The score of the whole group in each stage:2.89±0.68 for precontemplation stage,3.05±0.42 for contemplation stage,2.99±0.62 for action stage and 2.79±0.51 for maintenance stage3.The pain score in each stage:4.38±0.74 in precontemplation stage,3.64±1.23 in contemplation stage,1.83± 1.72 in action stage and 2.33± 1.16 in maintenance stage.Variance analysis showed that the difference of pain score in each stage was significant(F=5.752,P<0.05).4.The QOL score in each stage:As a whole,the QOL score of CHD patients were higher in higher stage,the difference was significant in physical limitation(F=5.807,P<0.01)and disease awareness(F=3.393,P<0.05).5.There was a negative correlation between pain intensity and management stage(P<0.05),and pain intensity was negatively correlated with PL,AS,AF,TS and DP,while pain self management stage was positively correlated with PL(P<0.01)and DP(P<0.05).6.Place of residence,marital status and individual monthly income were used as independent variables in ordinal logistic regression analysis according to the results of single factor analysis of variance.The results of ordinal logistic regression analysis showed that the individual monthly income was an influential factor in the self management stage of pain(P<0.05),the higher the personal monthly income,the better the pain self-management level of patients,and there was no correlation with the other variables.Conclusion1.The patients with coronary heart disease are mostly in the lower stage(precontemplation stage and contemplation stage),these patients do not know how to control the pain.2.As the stage increases,the level of pain in the patient will decrease and the quality of life will rise.3.Personal monthly income was indicated to affect the stage of self pain management.