永久起搏器植入患者疾病不确定感及其影响因素分析

目的调查分析永久起搏器植入患者的疾病不确定感状况及其影响因素,为评估患者疾病不确定感和提出针对性的干预措施提供依据。方法采用自制的一般资料问卷、Mishel疾病不确定感量表(MUIS-A),对116例行永久起搏器植入术治疗严重心律失常患者进行调查,分析其影响因素。结果 116例患者的疾病不确定感总分为66~121分,平均(80.96±9.46)分,其中23例属低水平疾病不确定感,90例属中水平疾病不确定感,3例属高水平疾病不确定感。按疾病不确定感各维度平均得分由高到低排序:不明确性(33.87±4.85)分,复杂性(18.21±3.03)分,信息缺乏(17.47±2.93)分,不可预测性(11.41±2.46)分。不同性别、年龄、文化程度、家庭人均月收入、户口所在地、医疗方式的永久起搏器植入患者疾病不确定感得分比较,差异无统计学意义;不同病程的永久起搏器植入患者疾病不确定感得分比较,差异有统计学意义(P0.05)。多元线性回归分析结果显示,病程[t 3.938,95%CI(2.549,7.708)]是疾病不确定感水平的主要影响因素(P0.05)。结论 116例行永久起搏器植入术的患者中,75.9%的患者疾病不确定感处于中等水平,20.7%的患者疾病不确定感处于低水平,3.4%的患者疾病不确定感处于高水平。多元线性回归分析显示,患者疾病不确定感的水平主要受病程影响,病程越长,疾病不确定感越高。护士应根据患者的疾病不确定感水平,针对性的提供信息支持,给予护理措施,从而降低患者的疾病不确定感。

Study of disease uncertainty among patients with permanent pacemaker implanted and its influencing factors

Objective The study analyzed the disease uncertainty of patients with permanent pacemaker implantation and its influencing factors, which provided basis for assessing patients' uncertainty and providing targeted intervention measures. Methods A homemade general questionnaire, Mishel disease uncertainty scale (MUIS-A) was used to investigate the effects of 116 permanent pacemaker implantation in patients with severe arrhythmia. Results Among the 116 patients, the total score of the disease uncertainty was 66 ~ 121, the average was 80.96±9.46, among them, 23 cases belonged to low level disease uncertainty, 90 cases belonged to middle level disease uncertainty, and 3 cases belonged to high level disease uncertainty. According to the uncertainty of the disease, the average score of each dimension was ranked from high to low: inaccuracy (33.87±4.85), complexity (18.21±3.03),information deficiency (17.47±2.93), unpredictability (11.41±2.46). The scores of disease uncertainty in patients with permanent pacemaker implantation were not statistically different according to gender, age, education level, average monthly income of the family, location of registered permanent residence, and medical treatment. There were significant differences in the scores of disease uncertainty between patients with different course of permanent pacemaker implantation (P<0.05). The results of multiple linear regression analysis showed that the pathogenesis [t 3.938, 95% CI (2.549, 7.708)] was the main influencing factor (P< 0.05). Conclusion Among the 116 patients undergoing permanent pacemaker implantation, 75.9% of patients had a moderate level of disease uncertainty, 20.7% of patients had a low level of uncertainty, and 3.4% had a high level of uncertainty. Multiple linear regression analysis showed that the level of the patient's disease uncertainty was mainly affected by the course of disease. The longer the course, the higher the disease uncertainty. The nurses should provide information support to the patient according to the patient's disease uncertainty, and provide nursing measures to reduce the patient's sense of disease uncertainty.