A Study On The Relationship Between Disease Uncertainty And Coping Styles In Kidney Transplant Recipients

Objectives:(1)To study the status of uncertainty in illness in renal transplant recipients,and to analyze the influencing factors of renal transplant recipients.(2)Based on the theoretical framework of Mishel uncertainty in illness and combined with literature analysis,a theoretical model of uncertainty in illness and coping style of renal transplant recipients was constructed.(3)To verify the theoretical model and analyze the relationship between uncertainty in illness and coping style of renal transplant recipients.Methods:The convenient sampling method was used to recruit kidney transplant patients who visited the outpatient clinic of the first affiliated hospital of Xi’an Jiaotong University during the transplant follow-up period from April 2019 to July 2019.After the consent of the study participants,the kidney transplant recipients voluntarily filled in the informed consent.The questionnaire included the general information questionnaire,the Mishel’s uncertainty of illness scale,thel 2-item of Intolerance of Uncertainty Scale,the Stress Appraisal Measure and the Medical Coping Mode Questionnaire.SPSS 17.0 statistical software package was used for general statistical analysis,AMOS(Analysis of Moment Structures)21.0 statistical software was used to verify the constructed model.Results:(1)In this study,a total of 272 questionnaires were issued and 13 questionnaires were lost.259 renal transplant recipients were finally included.There were 170 males and 89 females.The participants’ age was rangedfrom 18 to 58 years,with an average age of 36.63 ±8.54 years.(2)The average score ofuncertainty in illness of renal transplant recipients of this study was 87.86 ± 12.67.The average scores of each dimension were ambiguity(37.88±8.13),lack in information(19.34± 4.69),complexity(16.00± 3.22)and unpredictability(14.63± 2.62)from high to low,which were consistent with previous studies.(3)Among the 259 respondents,163 were more inclined to confront the disease,67 were more inclined to avoid it,and the remaining 29 weremore inclined to be acceptance-resignation.(4)The average score of intolerance of uncertainty of 259 renal transplant recipients was 29.62 ± 8.55.The average score of the "expected behavior" dimension,the "inhibitory behavior" dimension and the "expected emotion" dimension were 13.82 ± 4.95(range 6～30),8.22 ± 2.51(range3～15),and 7.58 ± 2.72(range3～15),respectively.(5)The mean stress score of 259 renal transplant recipients was 11.39 ± 2.10.The average score of the "threat" dimension was 10.40± 3.06(range 4-19),while the average score of the "challenge”dimension was 11.81 ± 2.53(range 4～20).(6)After the structural equation model was modified,it indicated that the uncertainty in illness and uncertainty tolerance of renal transplant recipients had an indirect influence on the coping style,while the result of evaluation of the disease directly affected the selection of coping style.Conclusion:(1)The kidney transplant recipients surveyed generally had moderate levels of uncertainty in illness and uncertainty tolerance.(2)Factors influencing the uncertainty in illness of kidney transplant recipients included work status,education level,medical payment method,financial burden and abnormal renal function.(3)For the uncertainty in illness,most kidney transplant recipients respond choose the coping mode as confrontation,a few adopt the coping mode as avoidance and acceptance-resignation.(4)The uncertainty in illness of renal transplant recipients was only related to the coping style of "acceptance-resignation",while the correlation between the coping style of"confrontation" and "avoidance" was not statistically significant.(5)Uncertainty in illness among renal transplant recipients affected the selection of coping modes through the evaluation of the disease.