The Current Status And Correlative Factors Of Uncertainty In Illness In The Main Caregiver Of Patients With Heart Failure

Objectives To investigate and analyze uncertainty in illness and its influence factors among the main caregivers of patients with heart failure,explore the relationship between uncertainty in illness and social support,and to determine the effect of social support on the degree of uncertainty of the main caregivers and the mediating effects of anxiety.This will help increase the level of concern for the main caregivers and improve the main caregivers to bring about adverse outcomes;and provide theoretical basis for further intervention research to improvement of physical and mental health of the main caregivers,improvement of caregivers,improvement of prognosis and quality of life of patients with heart failure.Methods It was a cross-sectional study,243 main caregivers of heart failure patients who were hospitalized in the Department of Cardiology and Emergency Medicine of two tertiary general hospitals in a city of Henan Province was selects from August 2016 to October 2017.The general questionnaires,Mishel uncertainty in illness scale for family member(MUIS-FM),Self-Rating Anxiety Scale(SAS),and Social Support Rating Scale(SSRS)were used to conduct surveys on the main caregivers.The data was analyzed by using Epidata 3.1 and SPSS 17.0 software.Descriptive statistics were made with mean±standard deviation and number of cases(composition ratio).The independent samples t-test and one-way analysis of variance were used for comparison between groups.Correlation analysis was used for partial correlation analysis.The stratified stepwise regression analysis was used for multivariate analysis;The analysis adopts the sequential inspection method.Results 1 The status of the uncertainty in illness in the main caregivers of patients with heart failure All of the main caregiver's uncertainty in illness was a total score of(89.86±10.58),which was generally considered to have a higher level.Among them,the ambiguity score was(40.33±5.34),the complexity score was(22.38±3.50),the information deficiency score was(14.31±2.65),and the unpredictability score was(12.84±2.27).2 The univariate analysis of uncertainty of illness in the main caregivers of patients with heart failure There was a statistically significant difference in the uncertainty in illness among working conditions,relationship with the patient,education level,medical payment,different rates of HF admission,and family monthly income(P<0.05).Among them,unemployed,and their patients had a relationship with their children,elementary school and below,a family with a monthly income of less than 3,000 yuan,first hospitalization due to heart failure and self-paid had a higher score of uncertainty in illness.3 The status of anxiety and social support in the main caregivers of patients with heart failure The total score of anxiety was(58.66±7.43),and the overall level of anxiety was mild.The total score of social support was(39.01±5.56).The subjective support dimension score was(24.53±3.27),the objective support dimension score was(8.45±1.97),and the support usability dimension score was(6.03±1.89).Social support is generally at a medium level.4 Relationship between uncertainty in illness,anxiety and social support among the main caregivers of patients with heart failure Partial correlation analysis showed that there was a positive correlation between uncertainty in illness and anxiety,and the correlation coefficient was r=0.367,P<0.01.There was a negative correlation with social support,and the correlation coefficient was r=-0.292,P<0.01.5 Stratified stepwise regression analysis of factors affecting uncertainty of heart disease patients with heart failure The stratified stepwise regression analysis results showed that the first layer,the education level,and the number of patients admitted to the hospital with HF were included in the regression equation,explaining 43.8% of the total variation of the dependent variable.At the second level,the equation introduces two variables of anxiety and social support.It can explain 52.9% of the total variation of disease uncertainty,and R2 changes by 0.091.That is,it removes the influence of general data on the uncertainty in illness,and the level of anxiety.And the level of social support can explain the 9.1% of uncertainty in illness alone.6 Anxiety of the main caregivers in patients with heart failure in the analysis of the mediating effect between uncertainty in illness and social support.The mediating effect analysis used sequential tests.The results showed that there was a partial mediating effect between anxiety and social support and uncertainty in illness,and the mediating effect accounted for 63.5% of the total effects.Conclusions 1 The main caregivers of patients with heart failure have a high level of uncertainty in illness.2 The factors contributing to the factors affecting the uncertainty of illness were the number of admissions to heart failure,the education level of the primary caregiver,anxiety and social support.3 There was a positive correlation between uncertainty in illness and anxiety and a negative correlation with social support.Mediation variables anxiety is a partial mediating effect between social support and uncertainty in illness.