| Objective:To investigate the symptoms burden of patients with chronic heart failure by self-administered questionnaire,and the relationship between type D personality and symptoms burden,and to explore the mediating role of social support and coping style in type D personality and symptoms burden,so as to provide theoretical basis for the intervention of reducing symptoms burden of patients with chronic heart failure and improving symptoms burden.Methods:From May 2018 to October 2018,371 inpatients with chronic heart failure in the Department of Cardiology of 4 tertiary general hospitals in Jinan City,Shandong Province,were selected by convenient sampling.Type D personality questionnaire,perceived social support questionnaire,simple coping questionnaire and Memorial Heart Failure Symptom Assessment Scale were used to measure type D personality,social support,coping style and symptoms respectively.In addition,the social demographic characteristics and disease characteristics were measured by means of literature review and group discussion to develop general information questionnaires and clinical disease data questionnaires.SPSS 21.0 software and PROCESS plug-in are used for data statistics and analysis.Statistical methods include descriptive statistics,independent sample t-test,ANOVA,chi-square test,Pearson correlation analysis,etcResult:1.General demographic data and disease data of patients with chronic heart failureA total of 371 subjects were enrolled in this study.Their age ranged from 21 to 89 years,with an average age of 66.04± 13.8.Among them,199(53.6%)were male patients,290(78.2%)were married,196(52.8%)were primary school graduates or below,136(36.7%)were family income above 5000 yuan,and 217(58.5%)were paid by medical insurance.Cardiac function was classified as grade ? 223 cases(60.1%)The time of clinical diagnosis of heart failure ranged from 0.5 to 30 years,with an average of 3.51 ±4.86 years.The number of repeated admissions in half a year after discharge ranged from 0 to 8 times,with an average of 1.97± 1.42;the number of other diseases was 0-3;213 cases(57.4%)were optimistic about the disease,and 197 cases(53.1%)were unfamiliar with the knowledge of the disease.2.Symptom burden score of patients with chronic heart failure and its analysis in demographic data and disease dataThe results showed that patients with chronic heart failure had a high burden of symptoms.The average score of symptoms burden was 1.10±0.44,the average of physiological symptoms burden was 1.03±0.42,the average of psychological symptoms burden was 1.30±0.90,and the average of symptoms burden of heart failure was 1.11±0.61.Using independent sample t test and one-way ANOVA,the difference of symptoms burden score in general demographic data of patients with chronic heart failure was analyzed.The results showed that the symptoms burden score of patients with chronic heart failure was significantly different in gender and heart function classification,and the understanding of disease knowledge was significantly different in grouping(P<0.05).Among them,the symptoms burden score of female patients was higher than that of male patients(t = 4.661,P = 0.018),the symptoms burden score of chronic heart failure patients with grade ? of cardiac function was higher(F = 3.616,P = 0.028),and the symptoms burden score of patients with unfamiliar disease knowledge was higher(F = 5.970,P = 0.003).The symptoms burden score of patients with chronic heart failure was higher in other demographic sociological data and other disease resources.There was no significant statistical difference in material(P>0.05).3.Relevant Analysis of Type D Personality,Social Support,Coping Style and Symptom Burden in Patients with Chronic Heart Failure.Pearson correlation analysis showed that the scores of symptomatic burden dimensions were closely related to D-personality,social support and coping style dimensions in patients with chronic heart failure.Among them,type D personality was positively correlated with symptom burden score(r = 0.308,P<0.01);social support was negatively correlated with symptom burden score(r =-0.333,P<0.01);coping tendency was negatively correlated with symptom burden score(r =-0.593,P<0.01).In addition,there was a significant negative correlation between type D personality and social support(r ?-0.489,P<0.01)and coping tendency(r =-0.460,P<0.01),while there was a significant positive correlation between social support and coping tendency(r = 0.570,P<0.01).4.The mediating effect of social support and coping style on type D personality and symptoms burden in patients with chronic heart failure.Taking the total score of symptoms burden of patients with chronic heart failure as dependent variable,social support and coping propensity as mediating variable,and type D personality as predictive variable.Model 1 showed that type D personality could predict symptoms burden positively(? = 0.668,P<0.001).After social support was added,the absolute regression coefficient of type D personality to predict symptoms burden decreased(?=0.477,P<0.001).This indicated that social support played a mediating role between type D personality and symptoms burden.Type D personality indirectly predicted symptoms burden through the mediating role of social support.The effect was ? = 0.192(-0.918*0.209),and the mediating effect was 28.7%(0.192/0.668).Bootstrap test showed that the 95%confidence interval of social support mediation effect was(0.084-0.312,P<0.001),excluding zero,indicating that social support mediation effect existed significantly.Model 2 showed that type D personality could significantly and positively predict symptomatic burden(?= 0.668,P<0.001).After adding coping tendency,the absolute regression coefficient of type D personality to predict symptomatic burden decreased(? = 0.197,P<0.05),indicating that coping tendency played a mediating role between type D personality and symptomatic burden.Type D personality indirectly predicted symptomatic burden through the mediating role of coping tendency.The effect was ? = 0.471(-0.839*0.561),and the mediating effect was 70.5%(0.471/0.668).Bootstrap test showed that 95%of the confidence interval of the mediating effect of coping tendency was(0.355-0.601,P<0.001),excluding zero,indicating that the mediating effect of coping tendency was significant.The model is shown in Figure 35.Social support and coping style are the chain mediating effects between type D personality and symptoms burden in patients with chronic heart failure.According to the mediation effect test method,the process plug-in is used to test the mediation effect.Symptom burden was taken as dependent variable,type D personality as independent variable,social support and coping tendency as mediating variables to construct a multi-mediating model,and Process plug-in was used to test mediating model 6.The results showed that type D personality could significantly predict symptomatic burden(? = 0.215,P<0.05)and negative predictive social support(? =-0.918,P<0.001)and coping tendency(? ?-0.456,P<0.001).Social support could significantly predict coping tendency(? = 0.417,P<0.001),coping tendency could significantly predict symptomatic burden(? =-0.573,P<0.001).The predictive effect of type D personality on symptom burden through social support was? =-0.028(0.031*-0.918).Bootstrap test showed that 95%of the confidence interval of social support mediation effect was(-0.137-0.066).The confidence interval crossed zero,indicating that mediation effect no longer existed.The predictive effect of type D personality on symptom burden through coping propensity was ? = 0.262(-0.456*-0.573).Bootstrap test social support mediator.The 95%confidence area of the effect was(0.152-0.398),excluding zero,indicating the existence of mediation effect;the indirect predictive effect of D personality on symptomatic burden was ?=0.220(-0.918*0.417*-0.573)through the multiple mediation effect of social support and coping tendency;the 95%confidence area of Bootstrap test for social support mediation effect was(0.156-0.307),excluding zero,indicating the existence of mediation effect.Conclusion:1.Chronic heart failure patients have a high burden of symptoms,among which female patients,heart function grade ?,and unfamiliar with Disease knowledge are more worthy of attention.2.Social support of patients with chronic heart failure mediates the relationship between type D personality and symptoms burden,and coping tendency mediates the relationship between type D personality and symptoms burden.3.In addition,the social support and coping tendency of patients with chronic heart failure have multiple mediating effects between type D personality and symptom burden. |
PDF Full Text Request