The Relationship Between Self-Management Behavior And Self-Perceived Burden On Elderly Patients With Coronary Heart Disease

OBJECTIVEThis study takes elderly patients with coronary heart disease(CHD)as the research object to investigate the prevalence of integral self-perceived burden and explore its influencing factors about elderly CHD,then further explore the relationship between self-management behaviors and self-perceived burden.So as to draw medical staff's attention of assessing CHD patients' self-perceived burden and pave the way for laying down pointed nursing measures of intervention.METHODSElderly patients with CHD recruited from department of cardiology,a anonymous comprehensive tertiary hospital in Henan province between December,2018 and December,2019.The cross-sectional research design was adopted to investigate the elderly CHD patients using the general data questionnaire,Self-Perceived Burden Scale(SPBS),CHD Self-Management Behavior Scale(CSMS),Hospital Anxiety and Depression Scale(HADS).All the data are collected and imported into the database created by Epidata3.1.SPSS23.0 is employed for the following data analysis.Descriptive statistics: mean±standard deviation and number of cases(composition ratio);Group variance: t test and analysis;Correlation:Pearson correlation analysis;multivariate analysis: Multiple linear stepwise regression analysis;Mediating effect analysis :order Testing method.RESULTS1.The total score of self-management behavior for elderly CHD patients is in the middle level:93.96±14.22.All the dimensions in an decreasing order are daily life management(3.77±0.81),emotional management(3.63±0.69)and disease medical management(3.63±0.69).2.The total score of anxiety and depression of elderly CHD patients is 16.57±8.51.Patients with anxiety symptoms accounts for 43%,and with depressive symptoms takes up 52.2%.3.The elderly CHD patients have a total self-perceived burden of 31.90±6.08,which is generally at a moderate level.Dimensions of an decreasing order are physical burden(3.77±0.81),economic burden(3.77±0.81)and emotional burden(3.77±0.81).4.Elderly CHD patients have a negative correlation between self-management behavior and self-perceptive burden(r=-0.462,P<0.01);self-management behavior and anxiety and depression are also negatively correlated(r=-0.228,P<0.01);There is a significant positive correlation between anxiety and depression,and self-perceptive burden(r=0.483,P<0.01).5.Multivariate stepwise regression analysis was conducted with self-perceived burden as the dependent variable,and variables with statistically significant differences as independent variables in single factor analysis.The results show that the degree of self-care,education,history of stent implantation,and CHD types are factored in the regression equation,interpreting 27.4% of the total variation.6.Sequential test is adopted for the analysis of mediating effect.The results show that anxiety and depression exerts partial mediating effect between self-management behavior and self-perceived burden.CONCLUTIONS1.Elderly CHD patients have a relatively low level of self-management behavior,bearing comparatively heavy self-perceptive burden,and feeling obvious anxiety and depression.2.The self-management behavior of elderly CHD patients is negatively correlated with the burden of self-perception;education,self-care ability,history of stent implantation treatment,CHD classification and other factors contribute to the self-perceived burden of elderly CHD patients.3.Anxiety and depression have a partial mediating effect between self-management behavior and self-feeling burden.