| ObjectiveTo investigate the level of resourcefulness in patients with Coronary Heart Disease(CHD)in community,and to analyze the influential factors of the resourcefulness,depression and coping modes for patients with CHD in community.Discuss the effects of the resourcefulness training on the resourcefulness,depression,and coping modes for patients with CHD in community.It might provide the references for future research on community nursing staff.Methods1.Totally 311 patients with CHD in 4 community health service centers in Shaoguan were selected and investigated with the general information questionnaire,Resourcefulness Scale(RS),The Center for Epidemiological Studies Depression Scale(CES-D),Medical Coping Modes Questionnaire(MCMQ).The patients' current status of the resourcefulness,depression,coping modes and their influencing factors were investigated and analyzed.2.Compare the different materials of patients' age,degree of education,time of illness,et,patients in 4 community health service centers in Shaoguan were choosen as the interviewees.In order to understand the patients' needs for resourcefulness training,based on the concept of resourcefulness to darft the interview outline,a semi-structured,in-depth interview was conducted on patient until there's no new information or theme appearing.Finally fourteen patients were selected.3.The 36 CHD patients in Xihua community health service center interns were as the intervention group,and the 36 CHD patients in Fengcai communit-y health service center interns were as the control group.The demographic details,resourcefulness,depression,and coping modes between the two groups were respectively compared.The patients in the intervention group were given the resourcefulness training for eight weeks besides daily health education as those in the control group.Scores of resourcefulness,depression and coping modes were compared between the two groups.4.Statistical Package for the Social Sciences(SPSS)22.0 was used to analyze the data,the statistical methods involved statistical description t-test,linear correlation,chi-square test,and multiple linear model.Results1.The total mean score of resourcefulness of the patients was(71.23±15.02),the score range is from 21 to 130,personal resourcefulness score is(41.06±10.40),social resourcefulness score is(30.14±5.60).Age,degree of education,time of illness and the number of chronic diseases were the influential factors for the CHD patients' resourcefulness.These five factors explained 69.1% of the total variance.2.The total mean score of the patients' depression was(16.99±9.43),in the study of 311 cases,150 patients were with depression,the rate of depression is 48.23%.The scores of the four dimensions is depressive emotion(7.72±4.26),positive emotion(7.13±2.45),somatoform disorder(3.50±2.97)and interpersonal(0.91±0.97).Degree of education,the number of chronic diseases,time of illness,number of hospitalization and personal monthly income were the influential factors for the CHD patients' depression.These factors explained 59.4% of the total variance.Personal resourcefulness and social resourcefulness are also influential factors for depression,they explained 58.8% of the total variance.3.The CHD patients' face coping mode score was(16.07±3.20),The avoidance coping mode score was(15.99±3.34),The yield coping mode score was(9.89±3.09).Degree of education,occupation,time of illness and the number of chronic diseases were the influential factors for the CHD patients' face coping mode,these factors explained 49.6% of the total variance.Age,degree of education,number of hospitalization,occupation were the influential factors for the CHD patients' avoidance coping mode,these factors explained 43.1% of the total variance.Degree of education,time of illness,age were the influential factors for the CHD patients' yield coping mode,these factors explained 57.9% of the total variance.4.The CHD patients' resourcefulness was negative correlated to the patients' depression(r=-76.7.0%,P<0.01).Resourcefulness was positive correlated to the patients' face and avoidance coping mode(rf=-70.3%,ra=62.1%P<0.01).5.Five themes were concluded from qualitative interview of the 14 CHD patients: illness uncertainty,personal resourcefulness was higher than social resourcefulness,personal resourcefulness was not enough to cope with the disease stress and resourcefulness training needs were strong demanded,repositioning,expect social support.6.Before the intervention,there were no significant differences for the demographic details,resourcefulness,depression and coping mode between two groups(P > 0.05).7.After resourcefulness training,CHD patients' resourcefulness and its dimension scores[resourcefulness was(70.89±11.18),personal resourcefulness was(43.25±7.51),social resourcefulness was(27.64±4.99)] were more significantly improved than before[(59.14±10.80),(35.06±6.81),(24.08±4.92)] in the intervention group(P<0.05);CHD patients' resourcefulness and its dimension scores were more significantly improved in the intervention group than those in the control group [(61.56±9.00)?(37.67±6.28)?(23.89±4.13)](P<0.05).8.After resourcefulness training,CHD patients' depression score(20.56±3.84)was significantly decreased(20.56±3.84)than before(P<0.05).Except the somatoform disorder dimension of depression was no distinct difference than before(P>0.05),the other three dimensions were all changed(P<0.05).Compare with the control group,we could draw the same conclusion.9.After resourcefulness training,CHD patients' face coping mode score(15.86±2.30)and avoidance coping mode score(18.50±2.71)were significantl-y improved than before[(14.31±2.45),(17.08±2.81)](P<0.05),the yield coping mode score(8.75±1.90)was significantly decreased than before(13.08±2.10)(P<0.05).Compare with the control group's face coping mode score(14.22±2.04)and avoidance coping mode score(15.69±2.30),the intervention group's score was significantly improved(P<0.05),compare with the control group's yield coping mode score(13.11±2.23),the intervention group's score was significantly decreased(P<0.05).Conclusions1.The CHD patients' resourcefulness level is in the middle range.Age,degree of education,time of illness and the number of chronic diseases were the influential factors for the CHD patients' resourcefulness.2.The incidence of depression of CHD patients in community is higher.The CHD patients' resourcefulness was negative correlated to the patients' depression.3.CHD patients in community inclined to choose an avoidance or yield coping mode.And resourcefulness was positive correlated to the patients' face and avoidance coping mode,negative correlated to the patients' yield coping mode.4.Resourcefulness training could improve the CHD patients' resourcef-ulness level,decrease depression,and promote patients to choose positive coping mode from negative coping mode. |
PDF Full Text Request