老年冠心病住院患者疾病不确定感现状及影响因素分析  

Analysis of uncertainty in illness and influencing factors in elderly inpatients with coronary heart disease

作　　者：邵悦[1] 丁飚[1] 何英姿[1] 金燕萍[1] Shao Yue;Ding Biao;He Yingzi;Jin Yanping(Department of Gerontology,the Sixth People's Hospital Affiliated to Shanghai Jiaotong University,Shanghai 200233,China)

机构地区：[1]上海交通大学附属第六人民医院老年病科,上海200233

出　　处：《中国医学前沿杂志（电子版）》2020年第12期140-144,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：上海市第六人民医院院级科学研究基金(院内-2040)。

摘　　要：目的探讨老年冠心病住院患者疾病不确定感现状及影响因素。方法选取2018年1月至2019年1月上海交通大学附属第六人民医院收治的312例老年冠心病住院患者为研究对象,采用Mishel疾病不确定感量表(Mishel's uncertainty in illness scale,MUIS)评估其疾病不确定感水平,并探讨老年冠心病住院患者疾病不确定感的影响因素。结果全部患者的MUIS评分为39~113(85.72±12.89)分,总体处于中等水平。其中,不可预测维度的条目平均分最高,复杂性维度的条目平均分最低。年龄≥75岁、未婚、丧偶或离异、文盲或小学、家庭人均月收入<3000元、未合并糖尿病、有冠心病家族史、社会支持评定量表(social support rating scale,SSRS)评分≤19分、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)评分≥21分、汉密尔顿抑郁量表(Hamilton depression scale,HAMD)评分≥35分的患者MUIS评分均显著高于年龄60~74岁、已婚、大专及以上、家庭人均月收入>5000元、合并糖尿病、无冠心病家族史、SSRS评分≥30分、HAMA评分<14分、HAMD评分<20分的患者(均P<0.05)。多元线性回归分析结果表明家庭人均月收入、SSRS评分、HAMA评分均是老年冠心病住院患者疾病不确定感的独立影响因素(均P<0.05)。结论老年冠心病住院患者家庭人均月收入越低、社会支持水平越低、焦虑越严重,其疾病不确定感越强,临床上应给予针对性健康宣教与心理干预。Objective To investigate the uncertainty in illness and influencing factors in elderly inpatients with coronary heart disease.Method Three hundred and twelve elderly inpatients with coronary heart disease admitted to the Sixth People's Hospital Affiliated to Shanghai Jiaotong University were enrolled for the study.Mishel's uncertainty in illness scale(MUIS)was used to evaluate the level of uncertainty in illness and to explore the influencing factors of uncertainty in illness in elderly inpatients with coronary heart disease.Result The score of MUIS in all patients ranged from 39 to 113 points,with an average score of(85.72±12.89)points,which was in the middle level.In the four dimensions,unpredictable dimension had the highest average item score,and complexity dimension had the lowest average item score.The score of MUIS in patients with age≥75 years,unmarried,widowed or divorced,illiterate or primary school education level,family income per capita<3000 yuan,no diabetes mellitus,family history of coronary heart disease,social support rating scale(SSRS)score≤19 points,Hamilton anxiety scale(HAMA)score≥21 points,Hamilton depression scale(HAMD)score≥35 points were significantly higher than those in patients with aged 60-74 years,married,junior college or above education level,family income per capita>5000 yuan,diabetes mellitus,no family history of coronary heart disease,SSRS score≥30 points,HAMA score<14 points,HAMD score<20 points(all P<0.05).Multivariate linear regression analysis showed that family per capita monthly income,SSRS score and HAMA score were the independent influencing factors of uncertainty in illness of elderly inpatients with coronary heart disease(all P<0.05).Conclusion The lower the family's per capita monthly income,the lower the level of social support,and the more serious the anxiety,the stronger uncertainty of the elderly inpatients with coronary heart disease about the disease.Clinically,targeted health education and psychological intervention should be given.

关 键 词：疾病不确定感 冠心病 危险因素 老年人 

分 类 号：R541.4[医药卫生—心血管疾病]