The Effects Of Cognitive Behavioral Intervention On The Illness Uncertainty,Coping Styles And Emotion Of Uremia Patients Undergoing Peritoneal Dialysis

Objectives 1.To survey the illness uncertainty,coping styles and emotion of uremia patients undergoing peritoneal dialysis.2.To describe the correlation between the emotion and uncertainty in illness,the coping styles and uncertainty in illness in uremia patients undergoing peritoneal dialysis.3.To study the effects of cognitive behavior intervention on the illness uncertainty,coping style and emotion of uremia patients undergoing peritoneal dialysis.Methods This study was a randomized controlled trai1.91 uremia patients undergoing peritoneal dialysis in the Nephrology Department of the First Affiliated Hospital of Guangxi Medical University were selected to be samples.91 patients were divided into two groups.45 in the control group and 46 in the intervention group.Demographic questionnaire,Mishel Uncertainty in Illness Scale-Adult(MUIS-A),Medical Coping Modes Questionnaire(MCMQ)and Profile Of Mood State-Short Form(POMS-SF)were used to survey the baseline condition of patients.The control group were received routine nursing care in nephrology department.According to the baseline condition,the intervention group were given cognitive behavior intervention on the base of routine nursing care in nephrology department,20～30 minutes a week for 12 weeks.The condition of illness uncertainty,coping style and emotion were surveyed at 4 weeks and 12 weeks during the intervention,to analysis the effectiveness of cognitive behavior intervention.Results 1.The average score of illness uncertainty in uremia patients undergoing peritoneal dialysis was 74.12±11.90,the patients with moderate uncertainty in illness accounted for 92.3%.2.The illness uncertainty of uremia patients undergoing peritoneal dialysis was positive correlation to resignation coping style,tension-anxiety,anger-hostility,depression-dejection,confusion-bewilderment and the overall mood,and negative correlation to confrontation coping style,vigor-activity.3.At 4 weeks during the intervention,the scores of tension-anxiety,depression-dejection and the overall mood were higher than before in the control group(P<0.05).The scores of total uncertainty,’ambiguity’ uncertainty,resignation coping style,tension-anxiety,anger-hostility,depression-dejection,confusion-bewilderment and to tal mood disturbance were lower than before in the intervention group(P<0.05).The scores of total uncertainty,’ambiguity’uncertainty,resignation coping style,tension-anxiety,anger-hostility,depression-dejection and the overall mood of intervention group were lower than that of control group(P<0.05).4.At 12 weeks during the intervention,there were significant increase in scores of tension-anxiety,depression-dejection and total mood disturbance in comparison with baseline measures of the control group(P<0.05).There weresignificant decrease in scores of uncertainty in illness,resignation coping style,the all negative emotions and the overall mood in comparison with baseline measures of the intervention group(P<0.05),while there were significant increase in the score of confrontation coping style(P<0.05).Compared with the control group,There was a significant increase in the score of confrontation coping style(P<0.05),while decrease in the scores of uncertainty in illness,resignation coping style,the all negative emotions and the overall mood(P<0.05).Conclusions 1.The illness uncertainty in uremia patients undergoing peritoneal dialysis was generally in moderate level.2.There is a relationship between coping styles and the illness uncertainty,emotion and the illness uncertainty in uremia patients undergoing peritoneal dialysis.3.Cognitive behavior intervention could decrease the level of uncertainty in illness of peritoneal dialysis patients with uremia effectively.4.After the cognitive behavior intervention,the peritoneal dialysis patients with uremia tent to use more positive coping style and less use of negative coping style.5.After the cognitive behavior intervention,the negative emotions of peritoneal dialysis patients with uremia was clearly relieved.