冠状动脉支架植入患者与家属疾病不确定感现况及其影响因素

Uncertainty in illness in patients with coronary artery stenting and their families and its influencing factors

目的明确冠状动脉支架植入患者及家属疾病不确定感现况,探讨患者与家属疾病不确定感影响因素及其之间的相互影响。方法采用整群抽样法选取2020年5月至12月空军军医大学第一附属医院心血管内科行冠状动脉支架术的182例患者及家属182名作为调查对象。通过中文版疾病不确定感患者量表(MUIS-A)和中文版疾病不确定感家属量表(MUIS-FM),分别了解患者与家属的疾病不确定感现况,结合多元线性回归明确其影响因素。采用SPSS 20.0统计软件进行数据分析。根据数据类型,组间比较分别采用t检验、方差分析及χ^(2)检验。结果冠状动脉支架术后MUIS-A得分为(77.77±11.68)分,MUIS-FM得分为(95.31±11.76)分。不确定性是影响患者疾病不确定感的重要因素,不可预测性是影响家属疾病不确定感的重要因素。患者疾病不确定感的影响因素:患者学历(初中和小学)、有并发症、家属对患者疾病的了解程度、患者收入、家属收入、家属不确定感总分(均P<0.05);家属疾病不确定感的影响因素:患者疾病不确定总分、家属家庭收入、家属健康状况较差及患者居住地(农村和城市)(均P<0.05)。结论冠状动脉支架植入患者与家属存在不同程度的疾病不确定感,且二者之间有较强的相互作用,提示医护人员在实施干预的时候,需同时关注患者与家属这两个群体,以达到最佳效果。

Objective To clarify the current status of disease uncertainty in patients with coronary artery stenting and their families and explore the influencing factors of the uncertainty and their mutual influence.Methods A total of 182 patients who underwent coronary artery stent implantation in the Department of Cardiology of the First Affiliated Hospital of Air Force Military Medical University from May to December 2020 were subjected by cluster sampling,and their 182 family members were enrolled at the same time.Mishel uncertainty in illness scale for adults(MUIS-A)and Mishel uncertainty in illness scale for family member(MUIS-FM)were used to understand the current status of the disease uncertainty of patients and family members.Multiple linear regression analysis was employed to clarify its influencing factors.SPSS statistics 20.0 was applied for statistical analysis.Data comparison between two groups was performed using student′s t test,Fisher exact test or Chi-square test depending on date type.Results The MUIS-A was(77.77±11.68)points in the patients after coronary stent implantation,and the MUIS-FM was(95.31±11.76)points in the family members.Uncertainty was an important factor affecting patient′s disease uncertainty,and unpredictability was an important factor affecting family member′s disease uncertainty.The influencing factors for the patient′s disease uncertainty were educational level(junior high school vs elementary school),complications,patient′s income,and family member′s income,knowledge on the disease and total score of uncertainty(all P<0.05).The influencing factors of family member′s disease uncertainty were total score of patient′s disease uncertainty,family member′s income,family members in poor health,and place of patient′s residence(rural vs urban areas)(all P<0.05).Conclusion The patients with coronary artery stenting and their family members have varying degrees of disease uncertainty,and there is a strong interaction between them.Our results suggest that medical staffs should pay special attention to the patients and their family members at the same time when implementing interventions to achieve the optional outcomes.