CAJ | 학술논문

目的调查体外循环心脏瓣膜手术患者疾病不确定感状况并探讨其影响因素,为制定有效干预措施提供参考.方法采用自行设计的患者一般资料问卷、Mishel疾病不确定感量表、Connor-Davidson韧性量表、医学应对方式问卷对广东省4所“三甲”医院心血管外科的208例体外循环心脏瓣膜手术患者分别在术前1d、出院前1d进行调查.结果体外循环心脏瓣膜手术患者术前1d疾病不确定感的总体均分为(99.09±11.41)分,92.3％的患者疾病不确定感水平处于中等.出院前1d疾病不确定感的总体均分为(90.33±10.32)分,91.8％的患者疾病不确定感水平处于中等.年龄、心脏瓣膜病类型、心脏瓣膜手术次数、乐观及屈服对疾病不确定感水平有显著正向影响,家庭平均月收入、自强、心理韧性总分及面对应对方式对患者疾病不确定感水平有显著负向影响.结论体外循环心脏瓣膜手术患者疾病不确定感水平处于中等,年龄、家庭平均月收入、心脏瓣膜病类型、心脏瓣膜手术次数、心理韧性与应对方式是疾病不确定感水平的主要影响因素.
목적 조사체외순배심장판막수술환자질병불학정감상황병탐토기영향인소,위제정유효간예조시제공삼고.방법 채용자행설계적환자일반자료문권、Mishel질병불학정감량표、Connor-Davidson인성량표、의학응대방식문권대광동성4소“삼갑”의원심혈관외과적208례체외순배심장판막수술환자분별재술전1d、출원전1d진행조사.결과 체외순배심장판막수술환자술전1d질병불학정감적총체균분위(99.09±11.41)분,92.3％적환자질병불학정감수평처우중등.출원전1d질병불학정감적총체균분위(90.33±10.32)분,91.8％적환자질병불학정감수평처우중등.년령、심장판막병류형、심장판막수술차수、악관급굴복대질병불학정감수평유현저정향영향,가정평균월수입、자강、심리인성총분급면대응대방식대환자질병불학정감수평유현저부향영향.결론 체외순배심장판막수술환자질병불학정감수평처우중등,년령、가정평균월수입、심장판막병류형、심장판막수술차수、심리인성여응대방식시질병불학정감수평적주요영향인소.
Objective To investigate the current status of uncertainty in illness in cardiac valvular surgery patients with cardiopulmonary bypass and analyze its influential factor,and provide reference for effective intervention.Methods A total of 208 cardiac valvular surgery patients with cardiopulmonary bypass were recruited from 4 cardiovascular surgery in Guangdong and were investigated with the self-designed questionnaire,Mishel Uncertainty in Illness Scale (MUIS),Connor-Davidson Resilience Scale (CD-RISC),Medical Coping Modes Questionnaire (MCMQ),in the preoperative day and the day before discharge.The data were analyzed by single-factor and multiple-factor analysis.Results The average score of uncertainty in illness in cardiac valvular surgery patients with cardiopulmonary bypass was 99.09±11.41,and 92.3％ of patients got a moderate uncertainty in illness level in the preoperative day.The average score of uncertainty in illness in the patients was 90.33± 10.32,and 91.8％ of patients got a moderate uncertainty in illness level in the day before discharge.Multiple linear regression indicated that,age,cardiac valvular disease types,number of cardiac valvular surgery,optimism and yield were the protective factors of uncertainty in illness level.Average monthly household income,self-improvement,scores of resilience and confront coping were the risk factors of uncertainty in illness level.Conclusion The level of uncertainty in illness in cardiac valvular surgery patients with cardiopulmonary bypass is moderate.Age,average monthly household income,cardiac valvular disease types,number of cardiac valvular surgery,resilience and coping style are factors influencing uncertainty in illness level of patients.