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Objective:To explore the mediating effects of disease perception on disease uncertainty and health behaviors among thrombolysis therapy in patients with acute ischemic stroke, to provide a theoretical basis for improving patient health behavior.Methods:By cross-sectional survey methods, from June 2021 to June 2022, a total of 123 thrombolysis therapy in patients with acute ischemic stroke were investigated by general information, Mishel Uncertainty in Illness Scale, Health Behavior Scale for Stroke Patients and Revised Illness Perception Questionnaire by convenience sampling method. The mediating effect of disease perception between disease uncertainty and health behavior was verified by structural equation model.Results:The scores of disease uncertainty, health behaviors and disease perception were (52.21 ± 7.67), (63.77 ± 9.40), (127.70 ± 26.19) points in patients with acute ischemic stroke. Health behaviors and each dimension including exercise, medication, instruction, nutrition, responsibility, tobacco and alcohol were negatively correlation between disease uncertainty ( r values were -0.762 to -0.411, all P<0.01), and positively correlation between disease perception ( r values were 0.689 to 0.912, all P<0.01). Disease uncertainty was a significantly negative predictor for health behaviors ( β= -0.71, P<0.01); disease perception was also a significantly negative predictor for disease perception ( β = -0.85, P<0.01). Disease uncertainty had a significantly indirect effect on the health behaviors for thrombolysis therapy in patients with acute ischemic stroke through disease perception, which showed the mediating effect of health behaviors accounts for 15.2% of total effect. Conclusions:Disease perception play a mediating role in the relationship between disease uncertainty and health behaviors among thrombolysis therapy in patients with acute ischemic stroke.
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Objective@#To investigate the status and influencing factors of disease uncertainty among caregivers of colorectal cancer patients receiving chemotherapy, so as to provide insights into psychological interventions among caregivers. @*Methods@#Caregivers of colorectal cancer patients hospitalized in Hunan Cancer Hospital, the Third Xiangya Hospital and the Second Xiangya Hospital for chemotherapy from March 2020 to December 2021 were recruited. Caregivers' demographics, health status, medical and nursing support and social support, as well as patients' demographics, frequency of chemotherapy and disease stage were collected using questionnaire surveys. Caregivers' disease uncertainty was evaluated using Chinese version of the Uncertainty in Illness Scale for Family Members, and factors affecting caregivers' disease uncertainty were identified using a multivariable linear regression model.@*Results@#A total of 318 caregivers were enrolled, including 115 men (36.16%) and 203 women (63.84%), with a mean age of (45.89±6.57) years, and there were 186 caregivers as patients' spouses (58.49%). The mean score of disease uncertainty was (86.65±10.82) points, and the scores of the unpredictability dimension, uncertainty dimension, complexity, and lack of information dimension were (3.21±0.35), (2.98±0.48), (2.84±0.49) and (2.36±0.59) points, respectively. There were 285 participants with a high level of disease uncertainty (89.62%), and multivariable linear regression analysis identified social support (β′=-0.199), medical and nursing support (β′=-0.118), patient's age (β′=-0.155) and stage Ⅲ and Ⅳ of colorectal cancer (β′=0.151) as factors affecting caregiver's disease uncertainty.@*Conclusion@#Caregivers of colorectal cancer patients with chemotherapy have a high level of disease uncertainty, which is affected by social support, medical and nursing support, patient's age and duration of disease.
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Objective:To understand the incidence of post-traumatic stress disorder(PTSD) in fathers with premature infants and analyze the risk factors.Methods:Conveniently, the 203 fathers of premature infants in NICU of Affiliated Hospital of Jining Medical University of Shandong Province from May to August 2021 were selected as the subjects to fill in the general data questionnaire, Perinatal Post-traumatic stress disorder Questionnaire-Chinese edition (PPQ-C), Parents, Perception of Uncertainty Scale, Social Support Rating Scale, Simplified Coping Style Questionnaire. Logistic regression was used to analyze the risk factors of PTSD and establish a nomogram model. ROC curve was used to verify the discrimination ofthe model. Hosmer-Lemeshow goodness-of-fit test and Calibration Plot were used to verify the calibration.Results:PPQ-C total score of 203 fathers was 17.17 ± 8.77, 81 fathers, symptoms were positive and the incidence of PTSD was 39.90%(81/203). Logistic regression analysis showed college degree ( OR = 0.297, 95% CI 0.116 - 0.763, P<0.05), very low birth weight ( OR = 2.491, 95% CI 1.027 - 6.044, P<0.05), sense of disease uncertainty ( OR = 1.038, 95% CI 1.012 - 1.066, P<0.05), negative coping style ( OR = 1.871, 95% CI 1.127 - 3.108, P<0.05) were risk factors of PTSD in fathers with premature infants. The nomogram model was established basing on the results of the Logistic regression analysis, and the ROC curve proved (AUC = 0.751) the model having a good discrimination.The Hosmer-Lemeshow goodness-of-fit test ( P = 0.974) and the calibration plot demonstrated that the prediction values tends to coincide with the actual monitoring values. Conclusions:A higher incidence of PTSD was observed in fathers with hospitalized premature infant. It was related to education level, the infants′s birth weight, disease uncertainty and coping style. Therefore, the nurses should give information support and psychological guidance according to the individual situation of the infants′ father to reduce the incidence of PTSD.
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Objective In order to understand the influence of disease uncertainty to emotion among advanced lung cancer chemotherapy patients, in order to guide the clinical nursing work. Methods A total of 146 advanced lung cancer chemotherapy patients were selected as the research object, using the general information, Disease Uncertainty Scale and Brief Profile of Mood States Scale for investigation. Results The disease uncertainty scores of advanced lung cancer chemotherapy patients were 77.91 ± 16.87; scores of emotion was 39.37 ± 18.72; they were positively correlated (r=0.363,P<0.01). Patients′family per capita income, cultural degree, two dimensions of disease uncertainty (uncertainty, poor information) were the main influencing factors of emotion (t=-4.947-4.603, P<0.05). Conclusions Advanced lung cancer chemotherapy patients with the higher level of disease uncertainty have more bad emotion. The patient's family per capita income level, cultural level and disease uncertainty will affect the mood of patients. Targeted intervention measures should be taken to reduce the patient′s disease uncertainty, and improve the patient′s emotion, improve the quality of life.
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Objective To explore the influence of therapeutic communication system on uncertainty and coping style of patients with lung cancer chemotherapy. Methods The Cancer Hospital Affiliated to Harbin Medical University, 236 cases of lung cancer patients as the research object, which, from April 2015 to April 2016 were 120 cases as the control group, from May 2016 to April 2017 of 116 patients admitted to the intervention group 116 cases divided into intervention group and control group of 120 cases, compared two groups of patients with general information, the difference was not statistically significant. , control group patients received routine nursing care, patients in the intervention group received nursing intervention in the treatment of communication on the basis of routine nursing, the amount of uncertainty in illness coping scale and Jalowiec scale at the end of the course of chemotherapy, to evaluate the two groups of patients. Results Accept the treatment communication intervention, intervention group of patients with lung cancer disease uncertainty score and each dimension score was (63.27±12.69),(12.97±3.16),(12.71±2.81),(12.96±3.44),(24.63±6.11)points and those were(71.26± 14.58),(14.43±3.27),(14.15±3.02),(14.83±3.17),(27.85±6.03)points respectively in the control group, the differences were significant , t=-4.495--3.488, P<0.01. The scores of lung cancer patients by face, optimistic, emotional support, 4 coping style was(1.83 ± 0.79),(2.01 ± 0.91),(2.13 ± 1.08),(1.80 ± 0.78) points in intervention group and(1.52 ± 0.69),(1.60 ± 0.68),(1.77 ± 0.85),(1.54 ± 0.66)points respectively in the control group, the differences were significant, t=2.760-3.911, P<0.01, the escape, conservative and resigned;and 4 self reliant coping style scores were(1.19 ± 0.63),(1.31 ± 0.67),(1.35 ± 0.68),(1.22 ± 0.55)points in intervention group, and(1.55 ± 0.61),(1.59 ± 0.73),(1.63 ± 0.74),(1.51 ± 0.64)points in control group (t =-4.458--3.028, P< 0.01).Conclusions Therapeutic communication system can effectively improve the degree of uncertainty in patients with lung cancer chemotherapy, and adopt a positive coping style to improve the quality of life of patients.
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Objective To evaluate the effect of a nurse-led case management intervention on arm function and uncertainty for women with breast cancer.Methods 90 women with breast cancer were divided into the intervention group and the control group according to their nurses,with 45 patients in each group.All participants were followed six months after surgery.The intervention group attended a 6-month nurse-led case management program,while the control group received the routine care and follow-up only.Questionnaires on arm function and uncertainty were administered 1 month,3 months and 6months after the surgery respectively.Score changes were compared by repeated-measure ANOVA and MANOVA.Results The arm function of the intervention group was better than the control group,except for the 10th day after the operation,there were significant differences at other three time points.The disease uncertainty level of the intervention group was better than that of the control group,except for the dimension of unpredictability,there were evident differences in other dimensions at other three time points.Conclusions The nurse-led case management intervention could improve arm function recovery and decrease the uncertainty to disease of breast cancer survivors.
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Objective To investigate the effect of informational support on disease uncertainty in liver cancer patients undergoing interventional therapy. Methods Sixty patients of liver cancer patients undergoing interventional therapy were randomly divided into the intervention group and the control group with 30 in each.The control group was treated with general treatment and care. The patients in the intervention group were given general treatment and care with a series of informational support interventions. Patients in the two groups were measured by uncertainty in illness scale (MUIS) at the day of admission,before operations and discharged from hospital. The measurement results were statistically analyzed. Results There was significant decrease about disease uncertainty scores both on the day before operation and the day before discharge in the intervention group compared to the day of admission. The decreasing score of uncertainty in illness in the intervention group was significantly greater than the control group on the day before operation and the day before discharge. Conclusions A series of informational support interventions could significantly reduce the diseases uncertainty in liver cancer patients undergoing interventional therapy.
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Objective To observe the influence of disease uncertainty ( DU) to patients' compliance with rehabilitation training ( CWRT) , shoulder joint movement (SJM) , and abilities in activities of daily living ( ADL) in post-operative breast cancer (BCPO) patients. Methods Sixty-seven BCPO patients uncertain about their health was assessed using Missals' DU protocol. They were then treated according to the breast cancer rehabilitation training plan recommended by the Japanese Cancer Association. CWRT, SJM and ADL were evaluated before and after treatment. Results The scores on dependency of recovery training, systematic remedy and the ability to change their life style were distinctly higher among patients with low DU scores than among those with high DU scores. The shoulder joint mobility in two groups was similar before the remedy, but became better after treatment. ADL category grades and ADL total scores in the two groups were similar before treatment, and had increased significantly after treatment. The item scores for defecating, diet, dressing and bathing, as well as ADL total scores, were significantly lower in the high uncertainty group. Conclusion DU is one of most important factors for BCPO patients. It can influence CWRT and therapeutic effects in rehabilitation.