Effect Of Uncertainty In Illness On Relocation Stress In Family Members Of Patients With Stroke Transferred From Neurological Intensive Care Unit

ObjectiveThe purpose of this study was to explore the status of uncertainty in illness,coping style,relocation stress and and to explore the effect of uncertainty in illness and coping style on relocation stress in the family members of patients with stroke transferred from NICU;A structural equation modeling(SEM)was constructed to explore the mediating effect of coping style between uncertainty in illnessfor family member and family relocation stress.MethodIn this study,a questionnaire survey was conducted among 270 family members of patients with stroke who met the inclusion and exclusion criteria with a convenience sampling method in a NICU ward of tertiary hospital,Guangdong Province,from January 2020 to November 2020,a total of 257 valid questionnaires were collected.The survey instruments included the following: patient general data questionnaire,family members of patients general data questionnaire,Mishe1 uncertainty in illness scale for family member(MUIS-FM),Simplified coping style questionnaire(SCSQ)and Family relocation stress scale(FRSS).Eipdata 3.1 software was used to input data and verify the validity of the data by two researcher.SPSS 22.0software was used for descriptive analysis,multiple linear stepwise regression analysis,and hierarchical regression analysis.The structural equation model was constructed by AMOS24.0 software and to analyze the mediating effect of coping styles between uncertainty in illness for family member and family relocation stress.Results1.The total score(84.42 ± 17.86)points of MUIS-FM of family members of patients with stroke transferred from NICU,which is at a moderate level;The scores of the four dimensions of scale were the lack of information dimensionality(16.54±3.82)points,the ambiguity dimensionality(35.58 ± 9.10)points,complexity dimension(22.54±5.68)points,unpredictability dimensional(11.76±3.21)points.2.In the SCSQ,The positive coping score(1.45±0.62)points;The negative coping score(1.51±0.68)points.The coping style of the family members tended to be negative coping.3.The total score of FRSS(40.362 ± 8.72)were in the moderate level;The scores of the three dimensions of scale were the dimension of transfer-out anxiety(13.91±4.55)points,the recognition dimension of the disease(15.56±4.42)points,the recognition dimension of the treatment condition and environmental change(10.89±2.61)points.4.The uncertainty in illness of family members had a negative effect on positive coping(β=-0.40,P <0.001)and positive effect on negative coping(β= 0.25,P < 0.01)of the SCSQ.5.The negative coping of the SCSQ had a positive effect on family relocation stress(β= 0.30,P < 0.001).6.The uncertainty in illness of family members had a positive effect on family relocation stress(β=0.28,P<0.004).it had a positive effect on the dimension of transfer-out anxiety(β=0.27,P=0.006);it had a positive effect on the recognition dimension of the treatment condition and environmental change(β=0.25,P=0.02)7.There were statistically significant at the effect of uncertainty in illness of family members on family relocation stress in the severe dependence of different BI scores(P<0.05);there were statistically significant at the effect of uncertainty in illness of family members on family relocation stress in the male family members of different gender family members(P< 0.05);there were statistically significant at the effect of uncertainty in illness of family members on family relocation stress in the40-49 years old family members of different age groups family members.(P < 0.05).8.The negative coping of the SCSQ had a partly mediating effect between the uncertainty in illness of family members and family relocation stress(β=0.10,relative effect was 24.9%).Conclusion1.There were a moderate level at the uncertainty in illness of family members and the family relocation stress of patients with stroke transferred from NICU.The coping style of the family members tended to be negative coping.2.For the family members of patients with stroke transferred from NICU,the uncertainty in illness of family member had a negative effect on positive coping style and positive effect on negative coping style of the SCSQ.Negative coping style of the SCSQ had a positive effect on family relocation stress.The uncertainty in illness of family member had a positive effect on family relocation stres.The negative coping style of the SCSQ had a partly mediating effect between the uncertainty in illness of family member and family relocation stres.3.Reducing the uncertainty in illness from the stressor and improving the positive coping psychology from the mediator can reduce the family relocation stress.