心脏外科患者疾病不确定感现状及影响因素的调查与分析

Status and Influencing Factors of Uncertainty in Illness in Patients with Cardiac Surgery

为了评估心脏外科患者疾病不确定感的状况及影响因素,为降低患者病情不确定感提供理论依据,本研究采用方便取样选取100例心脏外科手术患者,运用自编问卷调查心脏外科患者疾病不确定感及其影响因素,采用单因素与多因素Logistic回归分析探讨心脏外科患者疾病不确定感的独立危险因素。心脏外科患者Mishel量表总分(99.23±13.56),处于中等病情不确定感;单因素分析结果显示不同医疗付费、合并慢性疾病、婚姻状况、工作情况、心脏手术史、家庭年收入、文化程度、年龄、术前焦虑患者的Mishel量表总分差异具有统计学意义(p<0.05);多因素Logistic回归分析结果显示:心脏手术史(OR=2.675,95%CI为0.876~10.843)、家庭年收入≤19999元(OR=2.754,95%CI为0.785~10.665)、初中及以下文化水平(OR=2.221,95%CI为0.598~9.214)、年龄>70岁(OR=3.043,95%CI为0.855~12.634)、术前焦虑(OR=2.657,95%CI为0.844~9.987)是心脏外科患者疾病不确定感的独立危险因素。本研究结论初步表明,心脏外科患者存在较高水平的疾病不确定感,医护人员应重视有心脏手术史和术前焦虑,且家庭年收入低、文化水平低和年龄>70岁的患者,加强心理护理,降低其疾病不确定感。

To investigate the statu s and influencing factors of uncertainty in illness in patients with cardiac surgery, and to provide a theoretical basis for reducing the uncertainty in illness level. 100 patients with cardiac surgery treated in our hospital from December 2015 to December 2017 were selected with convenient sampling method and investigated by the self-made questionnaire survey. Then the univariate and multivariate logistic regression analysis was used to investigate the independent risk factors for uncertainty of illness in patients with cardiac surgery. The total score of Mishel scale in the patients was (99.23±13.56) with a moderate uncertainty in illness level;The results of univariate analysis showed that the medicare payouts, combined chronic diseases, marital status, work conditions, cardiac surgery history, family annual income, education level, age, and preoperative Mishel scale scores were significantly different (p<0.05);Multivariate logistic regression analysis showed that cardiac surgery history (OR=2.675, 95%CI: 0.876~10.843), annual family income ≤19 999 yuan (OR=2.754, 95%CI: 0.785~10.665), junior high school education and below (OR=2.221, 95%CI: 0.598~9.214), age>70 years old (OR=3.043, 95%CI: 0.855~12.634), preoperative anxiety (OR=2.657, 95%CI: 0.844~9.987) were independent risk factors of the uncertainty in illness in patients with cardiac surgery. The preliminary conclusion of this study shows that the uncertainty in illness in the patients with cardiac surgery is at a relatively high level, patients with cardiac surgery history, preoperative anxiety, low family annual income, low education level, and age>70 years old should be paid more attention to strengthen psychological nursing and reduce uncertainty level.