丙型肝炎患者首次抗病毒治疗前疾病不确定感与社会支持、应对方式的相关性研究

The Relationship between Uncertainty in Illness,Social Support and Coping Style of Patients with Hepatitis C before Antiviral Treatment for the First Time

目的了解丙型肝炎患者在首次抗病毒治疗前疾病不确定感的状况,确认患者应对方式和社会支持的状况,探讨患者疾病不确定感与应对方式、社会支持的相关性。方法便利抽样选取2014年10月至2015年9月某院拟行抗病毒治疗的慢性丙型肝炎患者220例患者为研究对象,采用一般资料调查表、疾病不确定量表、社会支持评定量表、应对方式问卷对其进行问卷调查。结果丙型肝炎患者首次抗病毒治疗前疾病不确定感的得分为(88.79±15.63)分,处于中等水平;社会支持总分为(41.902±4.863)分,高于一般人群社会支持平均分(t=14.226,P<0.01),疾病不确定感与社会支持呈负相关(P<0.01);应对方式中"面对"和"回避"得分显著低于国内常模(P<0.05),"屈服"得分高于国内常模(P<0.01);疾病不确定感各维度分别与"面对"、"回避"呈负相关(P<0.01),与"屈服"呈正相关(P<0.01)。结论疾病不确定感在丙型肝炎患者抗病毒治疗前普遍存在,且多数患者处于中等水平;与一般人群比较,患者有较高的社会支持,且社会支持高者疾病不确定感的程度低,反之则高。疾病不确定感水平与应对方式密切相关,可指导患者采取有效的应对方式如"面对"和"回避"等,以降低疾病不确定感。

Objective To understand the level and status of illness uncertainty,coping style, and social support of patients with hepatitis C before antiviral treatment for the first time, and find out the correlation between illness uncertainty, coping style, social support.Methods By convenience sampling, 220 cases were selected and investiga- ted by using general data questionnaire, disease uncertainty scale（MUIS - A）, social support rating scale（SSRS）, coping styles questionnaire（MCMQ）.Results The score of uncertainty in illness in patients with hepatitis C before antiviral treatment for the first time was（88.79 ± 15.63）, which was in the medium level.The total score of social support in patients（41.902 ± 4.863）was higher than the average social support in general population, and the differ- ence was statistically significant（t = 14.226,P〈0.01）,uncertainty in illness and social support were negatively cor related（P〈0.01）.The score of confrontation and avoidance score were lower than the national norm（P d0.05）, resignation score was higher than the national norm（P〈0.01）.Patients of illness uncertainty in each dimension re- spectively was negatively correlated with confrontation and avoidance（P〈0.01）, but it was positively correlated with resignation（P〈0.01）.Conclusion Uncertainty in illness is common in patients with hepatitis C before antivi- ral treatment,and the majority of patients are in the medium level.Comparing with the general population, patients have higher social support and the higher social support, the lower degree of uncertainty in illness, and vice versa. The level of uncertainty in illness and coping style is closely related,leading the patients how to take effective cop- ing styles, such as confrontation and avoidance can significantly reduce the disease uncertainty.