Study On Acceptance Of Illness Current Situation And Influencing Factors In Patients With Coronary Heart Disease After Receiving PCI

ObjectiveTo understand the status quo of disease acceptance in patients with coronary heart disease treated with percutaneous coronary intervention(PCI),to analyze the correlation between disease acceptance and coronary heart disease awareness and knowledge,self-efficacy,coping style and perceived social support,and to explore the influencing factors of disease acceptance of patients with coronary heart disease after receiving PCI.To deeply understand the psychological feelings of patients with coronary heart disease after receiving PCI,and to provide a theoretical basis for nursing intervention of disease acceptance of patients with coronary heart disease after receiving PCI.MethodsIn this study,the quantitative research used cluster sampling to select242 patients with coronary heart disease after receiving PCI who were eligible for treated in 2 Grade 3A hospitals in Yueyang City,Hunan Province from July 2020 to December 2020 as the research objects.A questionnaire survey was conducted on general information questionnaire,acceptance of illness scale,CHD awareness and knowledge questionnaire,general self-efficacy scale,medical coping modes questionnaire and perceived social support scale.The data were statistically analyzed by SPSS20.0:including descriptive statistics,t test,analysis of variance,rank sum test,Pearson and Spearman correlation analysis and multiple linear regression analysis.Qualitative research adopted the purpose sampling method,and selected 12 patients with coronary heart disease after receiving PCI who had been included in the quantitative research as semi-structured in-depth interviews.Colaizzi seven-step analysis method was used to analyze the interview data.Results1.A total of 242 patients with coronary heart disease after receiving PCI were included in this study,the total average score of disease acceptance was(23.57±4.67),including 52 patients with low acceptance(21.5%),159 patients with moderate acceptance(65.7%)and 31 patients with high acceptance(12.8%).2.Univariate analysis:education,age,place of residence,marital status,occupational status,per capita monthly income,type of health insurance and whether or not to live alone,whether to experience major negative events in the last year,complications,course of disease,type of long-term medication had a statistically significant difference in the impact of disease acceptance score(P<0.05).3.Correlation analysis showed that the total score of disease knowledge cognition was positively correlated with the acceptance of disease(r was 0.608);the total score of self-efficacy was positively correlated with the acceptance of disease(r was 0.625);there was a positive correlation between face dimension and disease acceptance in coping style(r was 0.611),and the avoidance and yield dimension was negatively correlated with the acceptance of disease(r were-0.439、-0.462);The total score of perceived social support,the score of support within family and support outside family were positively correlated with disease acceptance(r were 0.609、0.584、0.536).4.Multiple linear regression analysis showed that face coping style,coronary heart disease awareness and knowledge,self-efficacy,whether to experience major negative events in the last year,course of disease,monthly household income per capita,working state,perceived social support entered the regression model,and the fitted equation was statistically significant(F=47.240,P<0.001).The coefficient of determination R~2=0.606,indicating that independent variables could explain the 60.6%variation of the acceptance of disease.5.Qualitative research results:The psychological experience of disease acceptance in patients with coronary heart disease after receiving PCI include the following 4 major themes and 8 sub themes.⑴Topic 1:Lack of disease knowledge:(1)not aware of symptoms of coronary heart disease;(2)lack of information about PCI;⑵Topic 2:The negative impact of disease on life:(1)effects of disease on daily life;(2)economic burden;⑶Topic 3:The mental state has changed:(1)feeling of guilt due to thoughts and financial burdens;(2)diversified psychological feelings when facing illness;⑷Topic 4:Expect family and social support and realize self-worth:(1)expect more family and social support;(2)desire to return to society and realize self-worth.Conclusions1.The acceptance of disease of patients with coronary heart disease after receiving PCI is at a moderate level.2.Factors influencing disease acceptance in patients with coronary heart disease after receiving PCI include face coping style,CHD awareness and knowledge,self-efficacy,whether to experience major negative events in the last year,course of disease,monthly household income per capita,working status,and perceived social support.3.Through qualitative research,we found that the psychological experience of disease acceptance in patients with coronary heart disease after receiving PCI includes the lack of disease knowledge(not aware of symptoms of coronary heart disease、lack of information about PCI)、the negative impact of disease on life(effects of disease on daily life、economic burden)、the mental state has changed(feeling of guilt due to thoughts and financial burdens、diversified psychological feelings when facing illness)、expect family and social support and realize self-worth(expect more family and social support、desire to return to society and realize self-worth).