Analysis Of Status Of Health Self-Management And Its Influencing Factors Of Patients With Decompensated Liver Cirrhosis

Research ObjectInvestigate the status quo and influencing factors of the health self-management in patients with decompensated liver cirrhosis,then to explore the influence of general clinical data,positive psychological capital,health literacy and social support on the patients of health self-management,so as to provide theoretical basis for formulating intervention measures and improving the health self-management ability of patients with decompensated liver cirrhosis.Research MethodsThis research is divided into two parts1.Qualitative study which applied the phenomenological approach to conduct interview analysis and investigation.Sixteen patients with decompensated liver cirrhosis who were hospitalized in hepatology Department of three first-class hospitals in Shandong Province from January 2020 were selected by purpose sampling method for semi-structured in-depth interviews.Colaizzi’s seven-step method would be used to analyze and sort out the phenomenological data.2.The quantitative research conducted by using convenient sampling method,selected patients with decompensated liver cirrhosis who were hospitalized in hepatology Department of three first-class hospitals in Shandong Province from February 2020 to December 2020 as the research objects for questionnaire survey,and conducted a questionnaire survey at the time of admitted to the hospital The survey tools were self-designed demographic characteristics and disease-related clinical data questionnaire,self management behavior scale for patients with liver cirrhosis,positive psychological capital scale,health literacy management scale and social support rating scale..The data analyzed by spss 25.0 software.The main statistical analysis methods include statistical description analysis,T-test,analysis of variance(least significance difference test or Newman-Keuls test would be used between multiple sample means),Spearman’ s rank correlation coefficient and multivariate linear regression analysis.Research ResultsThe qualitative interviews extracted four major themes and ten sub-themes:(1)Health self-management behavior experience included inadequate self-care ability,lack of health self-management skills,decreased medication compliance,and irregular diet management.(2)Physiological experience refers to the discomfort caused by disease.(3)Psychosocial experience included the negative emotions,poor positive psychological adjustment;deny pre-existing condition,role maladaptation,and lack of family-social system support.(4)Environmental experience including the economic income and reimbursement ratio limit medical treatment,inconvenient transportation in the place of residence,restrictions on medical treatment and narrow information channels.2.The status quo of the health self-management in patients with decompensated liver cirrhosisAmong 327 patients with decompensated liver cirrhosis in this research,the total score of the health self-management ability in the patients was(64.72±11.58),and the standardized score was(2.70±0.48).The overall score was showed moderate level After standardization,the scores of each dimension were ranked from high to low in order of daily life management(2.95±0.56),medication management(2.71±0.69),diet management(2.58±0.56),and disease monitoring management(2.49±0.69).3.Univariate analysis of health self-management in patients with decompensated liver cirrhosis.Univariate analysis showed that education levels,residences,and economic income had statistical significance in the group comparison of the health self-management behavior and its various dimensions in patients with decompensated liver cirrhosis(P<0.05);In addition,the number of hospitalizations was only different in the group comparison of total score of health self-management in patients with decompensated cirrhosis(P<0.05).4.Spearman rank correlation analysis of health self-management in patients with decompensated liver cirrhosis.Spearman rank correlation analysis showed that the overall of health self-management scores and its various dimensions was positively correlated with the level of positive psychological capital(rs=0.420,0.358,0.327,0.358,0.321),health literacy(rs=0.532,0.356,0.560,0.401,0.385)and social support(rs=0.787,0.605,0.563,0.609,0.616),(rs>0,P<0.05).5.Multivariate linear regression analysis of health self-management in patients with decompensated liver cirrhosis.The social support(β=0.490),positive psychology capital(β=0.335)and health literacy(β=0.171)all significantly positively affected the the overall level of the patients’ health self-management(R2=0.691),only the level of social support significantly positively affected the patients’ diet management score(β=0.937,R2=0.421).While the level of positive psychology capital(β=0.823)and health literacy(β=0.185)were independent positively factor for their daily life management(R2=0.956);Health literacy(β=0.343)and social support(β=0.364)were the protective factors for the medication management of patients with decompensated liver cirrhosis(R2=0.336),while the level of social support significantly positively affect the disease monitoring management(R2=0.262).Conclusions1.The related influencing factors of health self-management in patients with decompensated liver cirrhosis involve various fields such as physiology,psychology and environment.This phenomenological research was clarified the experience of patients in the process of self-management of health,and could be provided reference clues for nursing-related health education.2.The health self-manage ment of patients with decompensated liver cirrhosis was only at a moderate level.According to the difference of scores in each dimension,this research suggested that medical staff should focus on improving the level of patients’medication,diet and condition monitoring and management.3.The positive psychological capital health literacy and social support were important predictors of the overall level of health self-management in patients with decompensated liver cirrhosis.4.The patient’s diet management,medication management,and condition monitoring management level will improve with the improvement of their social support level Improving the patient’ s health literacy can improve the patient’ s daily life management and medication management level,and increasing the patient’s positive psychological capital can improve their daily life Management level.5.This was reminded that medical staff should pay attention to the psychological state of patients,guide patients to rebuild positive psychological capital,and help patients actively seek more family and social support,gradually improve health cognition,then form good health literacy,These measures would help patients maintain good health self-management behaviors for a longtime.