Study On Status Of Benefit Finding And Its Influencing Factors Among Elderly Patients With Chronic Diseases

ObjectivesThe high prevalence of chronic diseases among the elderly affects their quality of life and mental health.Previous studies have found that patients can experience benefit finding when they are ill.At present,there are few studies on the benefit finding of elderly patients with chronic diseases.There is a lack of scientific measurement tools.The primary objectives of this study were to investigate current status of benefit finding among elderly people with chronic diseases and to explore factors influencing their benefit finding based on the cognitive adaptation theory(CAT)and model of stress process,in order to improve the level of benefit finding in patients and promote patients' physical and mental health.MethodsThis study used mixed research methods,including literature review,qualitative research and quantitative research.The research content was divided into the following three parts:Part ?:Qualitative research on benefit finding experience of elderly patients with chronic diseases.Based on the literature review,researchers developed the first draft of interview outline.After expert modification and adjustment,the elderly patients with chronic diseases were interviewed qualitatively,and the positive experience of patients after the disease was precipitated.Part ?: Development of a questionnaire for the benefit finding of elderly patients with chronic diseases.According to the results of theoretical study,literature review and qualitative interview,the preliminary draft of the questionnaire was formed and the expert consultation was carried out.After preliminary revision of the questionnaire,a pre-survey was conducted,and the reliability and validity of the questionnaire were tested by item analysis,exploratory factor analysis,Cronbach's a coefficient and test-retest reliability analysis.Part ?: Study on the benefits of elderly patients with chronic diseases and their influencing factors.Total 320 elderly patients with chronic diseases recruited from 2 tertiary hospitals in Shanghai were investigated using the convenience sampling method.The benefit finding of elderly patients with chronic diseases was analyzed using descriptive analysis,and influencing factors were analyzed using nonparametric test,multiple regression.ResultIn the process of coping with the disease,the elderly patients with chronic diseases can experience positive changes.Specifically for spiritual growth,appreciation of life,positive changes in priorities,social support,new possibilities,personal growth,altruistic behavior and health behavior change.Combined with the results of theoretical research and literature research and qualitative interview,a questionnaire for the benefit finding of elderly patients with chronic diseases was compiled.The reliability and validity test results showed that the item-content validity indexes were 0.818~1,scale-content validity indexes were 0.91,suggesting good content validity of the questionnaire.Exploratory factor analysis showed 6 factors,including personal growth,health behavior change,appreciation of life,perceived social support,altruistic behavior and spiritual growth,and explained 66.86% of the variance.Item belonged to the exact dimension as the theory showed except 1 item.The Cronbach'a coefficient was 0.924,and the test-retest reliability was 0.902,indicating good reliability.A survey of 320 patients showed that patients' scores of benefit finding were high,the total score is 78.76 ± 16.72.The scores of illness perception,confronce coping,avoidance coping,resigtion coping,family support,social support and optimism tendency were 42.69±10.20,20.46±2.32,17.78±2.34,12.44±2.09,24.46±3.89,41.96±9.50,13.02±1.66.Several statistical analyses(nonparametric test,Spearson correlation analysis)indicated that factors influencing benefit finding were:(1)Demographics variables: Cultural level,pre-retirement career;(2)avoidance coping and resigntion coping;(3)family support and social support.The variables which showed significant difference in benefit finding were introduced to the multi-factor analysis.The result showed that resigntion coping,family support and social support entered logistic regression model of benefit finding,and explained 22.4% of the variance.Patients with high levels of resigntion coping,family support and social support were found to have high levels of benefit finding.ConclusionIn the process of coping with the disease,the elderly patients with chronic diseases can experience positive changes.The validity and reliability of the questionnaire was good,and it could be used as an instrument in studies exploring benefit finding among elderly patients with chronic diseases.Patients' scores of benefit finding were high,which were mediating by resigntion coping,family support and social support.Our findings indicated that the medical staff and patients' family members should guide the patients to take the strategy of resigntion coping,accept the fact that they were sick,adjust their mindset and increase their social support in order to promote patients to experience more benefit finding.