Structural Equation Model Of The Relationship Between Self-perceived Burden And Quality Of Life Among Patients With Coronary Heart Disease

Objectives(1)To investigate the status and influencing factors of quality of life in patients with coronary heart disease.(2)To establish the structural equation model of the relationship between self-perceived burden and quality of life in patients with coronary heart disease,clarify the mediating variables and their path relationships among variables,to provide a theoretical basic for clinical formulation of intervention measures for quality of life in patients with coronary heart disease.MethodsA cross-sectional study of a random sample of 266 patients with coronary heart disease admitted to two cardiovascular medicine departments in a tertiary hospital in Anhui Province was conducted between December 2021 and October 2022.They were interviewed using the General Information Questionnaire,Self-Perceived Burden Scale,Social Support Rating Scale,Benefit Finding Scale and the the Mos 36-Item Short Form Health Survey.The data were analysed using SPSS 26.0 software.Multiple stepwise regression analysis was used to investigate the factors influencing quality of life in patients with coronary heart disease and AMOS 26.0 software was used to draw structural equation models to analyse and validate the pathways and effect sizes between the variables.Results(1)The quality of life score of patients with coronary heart disease was(49.88±20.31).Univariate analysis showed that gender,age,religion,education,occupational status,marital status,per capital monthly household income,degree of self-care,type of disease,number of previous due to coronary heart disease,duration of disease,number of interventions,cardiac function class and number of complications of patients with coronary heart disease,if there are differences in these factors,the quality of life scores of patients were significantly different(P<0.05).Correlation analysis showed that perceived burden was negatively correlated with social support,benefit finding and quality of life(r=-0.760、r=-0.826、r=-0.801,P<0.05),while social support was positively correlated with benefit finding and quality of life(r=0.768、r=0.717,P<0.05),benefit finding was found to be positively correlated with quality of life(r=0.822,P<0.05).Multiple stepwise regression analysis showed that age,number of interventions,cardiac function grade,perceived burden and benefit findings were influencing factors of quality of life in patients with coronary heart disease(ΔR~2=0.843,F=143.207,P<0.001).(3)The structural equation model based on Amos shows good fitting.NC=1.939,RESEA=0.060,GFI=0.933,AGFI=0.900,NFI=0.955,IFI=0.978,CFI=0.978.In the model,the total effect of perceived burden on quality of life was-0.877,of which the direct effect was-0.339,and the indirect effect of social support and benefit finding on quality of life was-0.538.Conclusions(1)The quality of life of patients with coronary heart disease was at a low level,and age,number of interventions,cardiac function grade,perceived burden and benefit finding were the influencing factors of quality of life.This demonstrates the need for healthcare professionals to take into account the quality of life of their patients in order to improve their health status.(2)All the fit indexes of structural equation model achieve the expected results.The model showed that self-perceived burden had a direct effect on quality of life and an indirect effect on quality of life through social support and benefit findings,social support and benefit finding are mediators between self-perceived burden and quality of life.It is suggested that clinical workers can improve the quality of life of patients and promote their mental health by intervening the mediating variables such as social support and benefit finding.