Impact Of Illness Perceptions Intervention To Chronic Hepatitis B Patients And Their Spouses On Quality Of Life And Condition Of Patients

ObjectiveTo understand the relationship between illness perceptions, emotional adjustment, coping style, self-efficacy and how these factors affect the quality of life in patients with chronic hepatitis B.MethodsCross-sectional survey research design was used in our study. Illness perceptions, emotional adjustment, coping style, self-efficacy, marital satisfaction and quality of life in patients with chronic hepatitis B was surveyed with the corresponding scales. A total of 134 chronic hepatitis B patients participated in the study. Measurement scales included The Revised Illness Perception Questionnaire(IPQ-R), Positive and Negative Affect Scale(PANAS), Trait Coping Style Questionnaire(TCSQ), General Self-Efficacy Scale(GSES), Olson mariral quality questionnaire (ENRICH), and Quality of Life Scale for Patient with Chronic Hepatitis B(QLS-CHB).Results1. The emotional representations and coherence factors of illness perceptions were negatively correlated with emotional adjustment and coping style. The emotional representations factor was negatively correlated with self-efficacy. The control factor of illness perceptions was positively correlated with emotional adjustment, coping style and self-efficacy. Self-efficacy was positively correlated with emotional adjustment and coping style.2. The control factor of illness perceptions and emotional adjustment were positively correlated with quality of life in physical, psychological and social factors. Coping style was positively correlated with quality of life in all dimentions. The coherence and emotional representations factors were negatively correlated with quality of life in physical, psychological and social factors. Self-efficacy was positively correlated with quality of life in physical factor. The timeline and consequences factors of illness perceptions and marital satisfaction found no significant correlation with quality of life.3. The stepwise regression analysis on quality of life showed that:①The timeline factor has negative effects on quality of life in psychological and social factors;②The consequences factor has negative effects on quality of life in social factor;③The control factor has positive effects on quality of life in physical, psychological and social factors;④The coherence factor has negative effects on quality of life in physical and psychological factor;⑤Emotional adjustment has positive effects on quality of life in physical, psychological and social factors;⑥Coping style and self-efficacy have positive effects on quality of life in psychological factor.4. Through the estimation of mediating effects, emotional adjustment was proved to be a completely mediator between illness perceptions and quality of life; coping style and self-efficacy were proved to be a partly mediator between illness percptions and quality of life.Conclusions1. The control factor in illness perceptions and emotional adjustment are the positive factors to the physical dimension of quality of life, while the coherence factor is the negative factor; The timeline and coherence factors in illness perceptions are the negative factors to the psychological dimension of quality of life, while the control factor, emotional adjustment, coping style and self-efficacy are the positive factors; The timeline and consequences factors in illness perceptions are the negative factors to the social dimension of quality of life, while the control factor and emotional adjustment are the positive factor.2. Increasing as the control factor in illness perceptions, the patients' emotional adjustment, coping style and self-efficacy are improved. Decreasing as the coherence and emotional representations factors in illness perceptions, the patients'emotional adjustment and coping style are improved. The various dimensions of quality of life are improved with the improvement of coping style.3. The illness perceptions affected the patients'quality of life through emotional adjustment completely, coping style and self-efficacy partly.ObjectiveTo understand the affection of the spouses'illness perceptions, emotional adjustment on quality of life in patients with chronic hepatitis B.MethodsCross-sectional survey research design was used in this study. Illness perceptions, emotional adjustment and marital satisfaction of the spouses was surveyed with the corresponding scales. A total of 134 spouses of the chronic hepatitis B patients participated in the study. Measurement scales included The Revised Illness Perception Questionnaire(IPQ-R), Positive and Negative Affect Scale(PANAS), Olson mariral quality questionnaire(ENRICH).Results1. The timeline, consequences, control and emotional representations factors in illness perceptions between the patients and their spouses have no significant differences. The coherence factor in illness perceptions between them has significant differences. The spouses thought the patients'level of understanding their conditions was poorer than the patients'own recognition. The timeline, control and coherence factors in illness perceptions between the patients and the spouses have no significant correlation, while the consequences and emotional representations factors between them have significant positive correlation.2. The spouses'control factor in illness perceptions was positively correlated with the patients'quality of life in physical and social factors. The spouses'coherence factor in illness perceptions was positively correlated with the patients'quality of life in symptom factor. The spouses'emotional representations factor in illness perceptions was negatively correlated with the patients'emotional adjustment, self-efficacy and quality of life in physical, psychological, social factors. The spouses'emotional adjustment was positively correlated with the patients'emotional adjustment and quality of life in psychological factor. The spouses'coherence factor in illness perceptions was negatively correlated with their own emotional adjustment. The spouses'marital satisfaction and control factor in illness perceptions were positively correlated with their own emotional adjustment.3. The stepwise regression analysis on quality of life showed that:①The spouses'emotional adjustment has positively effects on the patients'quality of life in physical and psychological factors, and has an interaction with the patients'emotional adjustment;②The spouses' consequences factor in illness perceptions has negatively effects on the patients'quality of life in social factor, and has an interaction with the patients'consequence factor.③The spouses'control factor in illness perceptions has positively effects on the patients'quality of life in physical, psychological and social factors, and has an interaction with the patients'control factor.Conclusions1. The differences of illness perceptions between the patients and the spouses are not obvious. The spouses'control factor in illness perceptions is the positive factor to the patients'physical, psychological, social dimensions of quality of life, and the positive impact is through the patients'own control factor as a regulation. The spouses'consequences factor in illness perceptions is the negative factor to the patients'social dimension of quality of life, similarly, the impact is through the patients' own consequences factor as a regulation. 2. The spouses'emotional adjustment is the positive factor to the patients'physical and psychological dimensions of quality of life, and this impact is also through the patients'own emotional adjustment as a regulation.ObjectiveDiscussed the impact of illness perceptions intervention to the chronic hepatitis B patients and their spouses on quality of life and condition of the patients and its mechanism.MethodsThis study is a randomized controlled trial and the prospective study design including the psycho-intervention group and the drug treatment group as a control was used in the study. A systematic comparison about the differences before and after treatment was administered between the two groups in illness perceptions, emotional adjustment, coping style, self-efficacy, quality of life and liver function. Meanwhile, the predictive factors of improving the quality of life in patients were analyzed. According to the order of visits the patients were randomly allocated to either the intervention or control group. There were 65 patients in the intervention group and 69 patients in control group when started. However, there were 54 patients in the intervention group and 52 patients in control group completed the study at last. Both the patients and their spouses received the measurement of baseline indicators. Measurement scales included The Revised Illness Perception Questionnaire(IPQ-R), Positive and Negative Affect Scale(PANAS), Trait Coping Style Questionnaire(TCSQ), General Self-Efficacy Scale(GSES), Olson mariral quality questionnaire(ENRICH), and Quality of Life Scale for Patient with Chronic Hepatitis B(QLS-CHB). The indicators above mentioned were measured repeatedly after the 6 weeks,12 weeks' follow-up.Results1. All the factors of illness perceptions before and after the treatment show significant differences in both the intervention group and control group. The scores of control factor increased while the scores of the other factors decreased significantly. The differences before and after the treatment in all the factors of illness perceptions were significantly higher in the intervention group than that of control group.2. The scores of emotional adjustment, coping style and self-efficacy after the treatment in both the intervention group and control group has significantly increased. The differences before and after the treatment were significantly higher in the intervention group than that of control group.3. the repeated measures analysis of variance was executed to quality of life in all dimensions. The results are as follows:①The analysis to the symton dimension of quality of life showed that the main effect of time factor and group factor were both significant. The interaction between the two factors were also significant. Simple effect analysis showed that the two groups were significantly different at time 1, while had no significantly difference at time 2 or time 3.②The analysis to the physical dimension of quality of life showed that the main effect of time factor and group factor were both significant. The interaction between the two factors were also significant. Simple effect analysis showed that the two groups were significantly different at time 2 and time 3, while had no significantly difference at time 1.③The analysis to the psychological dimension of quality of life showed that the main effect of time factor become lack of significance by the effects of interaction with the coherence factor in illness perceptions and whether receiving the antiretroviral treatment. Instead, the main effect of group factor was significant by the effect of the coherence factor in illness perceptions. The interaction between time and group factors were also significant. Simple effect analysis showed that the two groups were significantly different at time 1 and time 3, while had no significantly difference at time 2.④The analysis to the social dimension of quality of life showed that the main effect of time factor and group factor were both significant. The interaction between the two factors were not significant.4. The differences before and after the treatment in all dimensions of quality of life were significantly higher in the intervention group than that of control group. The degree of improvement of liver function before and after treatment between the two groups had no significant differences except AST. The ALT, AST, TBIL and DBIL of liver function in the two groups has decreased after treatment and ALB increased.5. The patients'timeline and emotional representations factors in illness perceptions and coping style were the significant predictors to the quality of life. The spouses'consequences, coherence and emotional representations factors in illness perceptions and emotional adjustment were the significant predictors to quality of life of the patients.6. In the intervention group the differences of the timeline, consequences, coherence and emotional representations factors in illness perceptions were negatively correlated with the differences of the physical, psychological, social dimensions of quality of life and its total scores before and after treatment. The differences of control factor in illness perceptions, coping style, emotional adjustment and self-efficacy were positively correlated with the differences of the physical, psychological, social dimensions of quality of life and its total scores before and after treatment. The differences of coping style, emotional adjustment and self-effcacy were positively correlated with the difference of the symptom dimension of quality of life before and after treatment.Conclusions1. On the aspect of illness perceptions, the intervention has improved the patients'illness perceptions significantly. With the improvement of illness perceptions quality of life of the patients has improved sigificantly. The timeline and emotional representations factors in illness perceptions are the predictive factors to the improvement of quality of life. 2. On the aspect of emotional adjustment, the intervention has improved the emtion of the patients significantly and with the improvement of emotion quality of life of the patients increased.3. On the aspect of self-efficacy, the intervention has increased self-efficacy of the patients significantly and with the improvement of self-efficacy quality of life of the patients increased.4. On the aspect of coping style, the intervention has improved coping style of the patients significantly. The patients'quality of life is improved with the improvement of coping style. Coping style has a strong prediction to the improvement of quality of life.5. On the aspect of quality of life, both of the two groups have improved quality of life of the patients. The intervention group has a more effect than control group, especially in the dimension of physical and psychology.6. The intervention has an insignificant impact on the condition of disease perhaps because of the short period of intervention and follow-up.7. The spouses'consequences, coherence, emotional representations factors in illness perceptions and emotional adjustment are the predictive factors to the improvement of the patients'quality of life.