| Objectives1.This study aims to examines the status quo of social support,illness uncertainty,hope and fatigue in patients with rheumatoid arthritis,to analyze the influencing factors of social support,illness uncertainty,hope and fatigue in patients with rheumatoid arthritis.2.To identify the relationship between social support,illness uncertainty,hope and fatigue in patients with rheumatoid arthritis,to further explore the role of social support,illness uncertainty,hope and fatigue in patients with rheumatoid arthritis.MethodsThis study took a convenient sampling and conducted a cross-sectional survey for the patients with rheumatoid arthritis who were admitted to the rheumatism and immunology outpatient clinic and ward of two third-grade hospitals in Tianjin from May to October in 2019 and met the exclusion criteria.A total of 487 patients were enrolled in the study.The research instruments included General Information Questionnaire,Social Support Rating Scale,Mishel Uncertainty in Illness Scale,Herth Hope Index and the Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire.The statistical data was analyzed using SPSS 23.0 statistics software.Descriptive analysis,t-test,one-way analysis of variance,Person correlation analysis,multiple stepwise regression analysis were included.Statistical software AMOS 22.0 was used to analyze structural equation model.Results1.The average score of social support of patients with rheumatoid arthritis was(34.74±6.65).The results of single factor analysis showed that there were statistically significant differences in social support scores among patients with different gender,educational attainment,only child situation,marital status,residence area,household companion,work statue,average monthly income of the family,ways of medical payments,morning stiffness time and frequency of recurrence(P<0.05).2.The average score of uncertainty in illness of patients with rheumatoid arthritis was(75.74±11.80).The results of single factor analysis showed that there were statistically significant differences in uncertainty in illness scores among patients with different educational attainment,marital status,residence area,household companion,work statue,average monthly income of the family,ways of medical payments,status of receiving biological agent treatment,morning stiffness time and frequency of recurrence(P<0.05).3.The average score of hope of patients with rheumatoid arthritis was(33.02±5.35).The results of single factor analysis showed that there were statistically significant differences in hope scores among patients with different gender,educational attainment,marital status,residence area,household companion,work statue,average monthly income of the family,ways of medical payments,morning stiffness time and frequency of recurrence(P<0.05).4.The average score of fatigue of patients with rheumatoid arthritis was(32.72±10.85).The results of single factor analysis showed that there were statistically significant differences in fatigue scores among patients with different gender,age,educational attainment,marital status,residence area,household companion,work statue,average monthly income of the family,ways of medical payments,disease duration,morning stiffness time,surgical treatment of knee joint and frequency of recurrence(P<0.05).5.The results of correlation analysis showed that the fatigue was negatively correlated with social support and hope(r=-0.477?r=-0.703),and positively correlated with uncertainty in illness(r=0.591),uncertainty in illness was negatively correlated with social support and hope(r=-0.389?r=-0.644),and social support was positively correlated with hope(r=0.534).6.The results of multiple stepwise regression analysis showed that marital status,average monthly income of the family,morning stiffness time,household companion,only child situation and educational attainment could explain 32.4% of the variation in social support,and the regression model was statistically significant(F=22.841,P<0.001).Morning stiffness time,ways of medical payments,educational attainment,frequency of recurrence and work statue could explain 34.1% of the variation in uncertainty in illness,and the regression model was statistically significant(F=27.386,P<0.001).Frequency of recurrence,ways of medical payments,morning stiffness time,marital status,educational attainment,work statue,gender and household companion could explain 38.2% of the variation in hope,and the regression model was statistically significant(F=20.802,P<0.001).Hope,uncertainty in illness,frequency of recurrence,social support,average monthly income of the family and surgical treatment of knee joint could explain 59.0% of the variation in fatigue,and the regression model was statistically significant(F=98.483,P<0.001).7.The results of the structural equation model analysis showed that the fitting indexes were all within the reference range,and the data fitted well with the model.The uncertainty in illness and hope played a mediating role between social support and fatigue,and the relative size of intermediary effect was 64.14%.Conclusion1.For the patients with rheumatoid arthritis,they were at a moderately low level of social support,a moderate level of uncertainty in illness,a moderately high level of hope,and a moderate level of fatigue.2.Demographic variables and disease-related characteristics had impact on social support,uncertainty in illness,hope and fatigue in patients with rheumatoid arthritis.According to the characteristics of different patients,medical staff should give targeted health education and nursing measures.3.The higher the patient's social support level,the lower the level of uncertainty in illness,the higher the level of hope,and the lower the level of fatigue.4.A structural equation model was established for the relationship among social support,uncertainty in illness,hope and fatigue in patients with rheumatoid arthritis.The social support can directly affect the fatigue conditions of patients,and can also in directly affect the fatigue conditions through the mediation of uncertainty in illness and hope. |
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