| BackgroundsCoronary heart disease (CHD) has become the main threat to the human health; cardiovascular disease is the main cause of death around China. It has been reported that the illness course of CHD was strongly related to unhealthy lifestyle. In 1977. Gruntzing firstly applied percutaneous transluminal coronary angioplasty as a therapy of coronary artery disease, after that interventional therapy soon become very popular nationally and was regarded as the main treatment method for coronary heart disease.Presently, the success rate of direct coronary angioplasty and stent implantation has reached to 91%—97%, and can be applied to even more patients in near future. Seeing the benefits we get from this therapy, Researchers at home and abroad also noticed that patients who undergo interventional therapy were normally suffering from severe psychological stress, among kinds of emotional stress, anxiety is the most sifnificant. Anxiety and other emotional effects can have serious adverseeffects on patients, which may affect the course of operation, or even lead to heart attack. Pan Shuhui's study showed that the level of anxiety was strongly associated with patients' illness uncertainty, complexity and illness course. There exists high correlation between illness uncertainty and level of anxiety. Illness .uncertainty refers to the lack of ability to identify disease-related things. It is mainly produced by four aspects: unclear diagnosis; complex treatment plan and nursing care; lack of imformation related with diagnosis and severity of the disease; unpredictable disease prognosis. From this point, we find that illness uncertainty must intensely correlate with deficient information. At the same time many researches show that effective information support can greatly reduce the level of illness uncertainty. Sun Hong found that providing systematic information support to peri-operative breast cancer patients could significantly reduce their illness uncertainty; Ye Lvzhi reported that good information support will help patients correctly understand the treatment plan and evaluate it, hence relieve patients' psychological stress response. Jing Lushi claimed that pre-operative information support system of psychological intervention can significantly reduce preoperative, intraoperative level of anxiety. At present, conventional health education also provides information to patients treated with percutaneous coronary intervention, such as preoperative fasting and limb fixation, but these information is far from enough, and staying on the surface. Patients' individual needs are not realized. Plus, nurses usually play different roles from patients, and their views are also different from patients', they are not able to really realize patients' needs, say, nurses normally think that if one patient is diagnosed as negative result, he/she would not have any problem, however the fact is, people are still worrying about the truth of this diagnosis, what if the diagnosis is wrong? That is what they concern about. Therefore, to understand the needs of patients treated with percutaneous coronary intervention and provide accordantly with the real needs of patients, and specific information support would be necessary.ObjectivesIn this study, State Anxiety Inventory and the Chinese version of Uncertainty Scale translated by Shulian xu were applied.The survey conducted in the cardic ward 1 and 2 of the second affiliated hosipital of Zhejianag University, from Augst 2006 to January 2007. The level of anxiety and uncertainty were assessed in patients treated with PCI. Discussion focused on the effect of targeted information support on the degree of uncertainty and anxiety in PCI patients during perioperative period. Subjects were randomly divided into two groups .Both the experimental group and the control group were all de facto level of anxiety and uncertainty for the self-control study.The variance of each group at different time points were analysed; patients in the experimental group and the control group were compared by the level of anxiety and uncertainty; The drop degree of anxiety and uncertainty between adjacent time were compared at the same time. Medical Coping Questionnaire (TCSQ), the Social Support Scale (PSSS). Eysenck Personality Queslionaire (EPO) were applied in the study to test patients' coping style ,ocial support and personality; To discuss the relationship between the effect of targeted information support and some potent factors, such as patinets' demographic characteristics .clinical features of the disease ,personal coping style, social support, and personality; Self- designed questionnaire named "Information needs satisfaction" was used to survey whether patients' need to know the information related to disease and surgery have been satisfied, and to explore the real targeted information support to meet individual need , which will definitely improve the quality of health education.MethodsFrom August 2006 to January 2007, 126 Patients treated with PCI and met the inclusion criteria were selected by convenience sampling in the study. Patients metthe inclusion criteria were asked to fill in the State Anxiety Scale and Uncertainty of disease Scale in the admission. 118 patients got higher score in the Uncertainty and Anxiety Scale were screened out to be the object of study. In order to prevent mutual influence among patients, first 59 cases were arranged into control group,the remaining 59 cases were in experimental group. Medical Coping Questionnaire(TCSQ), the Social Support Scale(PSSS).Eysenck Personality Questionaire(EPO) were applied in the study to test experimental group subject's personal coping style , social support and personality. The experimental group received the conventional health education and targeted information support according to individual need from the researcher, while patients in the control group just received conventional health education from ward nurses. All the subjects were asked to fill in State Anxiety Scale and the Chinese version pf uncertainty scale (translated by XuShuLian, Taiwan, authorized to use) in the preoperativc night, 24 hours after the operation and a day before discharge, to test their degree of anxiety and uncertainty at different points. Variance among different points in each group was worked out to prove whether there are statistical difference in self cross-reference. At the same point, two groups were compared each other by their level of anxiety and uncertainty about disease. The drop-out value among different time were also compared between experimental group and control group. Then analyse the reason of difference, and discuss the efffect of targeted information support on the anxiety and uncertainty in patients treated with PCI. All the subjects filled in the Satisfaction of Information Needs questionnaire a day before discharge.Then count whether there exists difference in the extent of satisfaction of information support and analyze its reason. Single-factor analysis of variance and multivariate logistic regression analysis were applied to study the correlation between clinical characteristics ,demographic indicators, personal coping style , social support , personality and the effect of targeted information support.Results118 cases got higher score in anxiety and uncertainty in illness scale were randomly assigned to the control and experimental group, 58 cases respectively . There was no significant diffrence in the characteristics of subjects between the control group and experimental group. Patients in the control group have significantly higher anxiety in the day of admission, preoperative night and 24-hour after operation than national norm(p<0.05), while no significant difference was shown in the day before dischage. Among four points, no statistical difference was tested in the anxiety between the day of admission and preoperative night, 24 hours after operation and preoperative night by SNK law. Compared to the anxiety in the preoperative night and 24 hours after operation , there is significant decrease of anxiety in the day before discharge (p<0.05). Patients in experimental group are higher in anxiety in the day of admission and preoperative night than the national norm, while no significant difference in 24 hours after the operation and a day before discharge. SNK law proved the significant difference in the level of anxiety among different points. There was no significant difference in the level of anxiety in the day of admission between two groups. While in other points, that is preoperative night, 24 hours after operation, a day before discharge, significant difference in the level of anxiety was tested between two groups . Both two groups showed a downward trend in the level of anxiety among four points. So as to the comparision of drop-out value, only no significant difference exists in the pre-post operation. There is statistical difference among other adjacent points. Patients in the experimental group have higher level of uncertainty,which dropped notably pre-operative night ,24 hours after the operation and a day before discharge.The difference of uncertainty of disease and the dimension of uncertainty in illness issignificant among four points. The complex dimension of uncertainty in illness did not show significant difference between pre-operative night and 24 hours after operation, while significant difference among other points. Patients in the control group do not have significant difference in the uncertainty among the day of admission, pre-operative night and 24 hours after operation. But the difference of uncertainty is significant between the day of admisssion and the day before discharge. So as to the dimension of uncertainty, there are significant difference among different points, except the day of admission and pre-operative night. While there is no significant difference in four points in the dimension of complexity. Patients in experimental group and control group do have high degree of uncertainty in illness in the perioperative period. There is no difference in the degree between two groups in the day of admission. The level of uncertainty in the pre-operative night, 24 hours after operation, the day before discharge showed significant difference between two groups, and so as the dimension of ambiguity and complexity. The level of uncertainty in illness, ambiguity, complexity showed downward trend in both the experimental group and control group among four points, and the difference of drop-out value is significant between two groups. Information support satisfaction was investigated a day before discharge, which indicated that experimental group was better satisfied than control group, and the difference is significant. The level of anxiety was mainly affected by patients' gender, age and length of admission. Patients who have positive coping style and nervousness personality have better effect. And education, stent placement, history of hospitalization are important factors to influnce the intervention effect on uncertainty ;Regression analysis revealed that positive coping style and better social support have better intervention effect in the uncertainty in illness.Conclusion1. For PCI patients, their anxiety and uncertainty were at a high level by the perioperative period.Care workers should pay more attention to intervene the anxiety and uncertainty.2. The research demonstrated the present convention health education pattern to the patient anxious degree and disease indefinite feeling improvement is effective, the nursing staff needs to pay attention to the health education work. But the present health education lacks pointed, becomes a mere formality one, which informations thoroughly hasn't explored the patient what they need, so that not be able to meet the patient need. Treatment of patients with the disease can't change their environment and locations of the medical complex. It is suggested that the next health education work should strengthen this aspect the attention.3. To provide the pointed information support to the peri-operative patients with coronary intervention can obviously reduce the patient anxious and disease indefinite feeling level, this research's designed information support pattern is helpful in raises the clinical nurse's health instruction level.4. This study found that levels of anxiety in the patients with coronary intervention effect of intervention by gender, age and number of days in hospital before.usually male, the day before hospitalization than patients with coronary intervention and take the middle of coping styles and personality characteristics of nervous patients Anxiety of more satisfactory results were more suitable for this kind of information to support intervention, but the nursing staff cannot neglect to other type patient.5. The research indicated that high levels of education, initial hospitalization, have no coronary stent implantation patients and take the coping style and socialsupport for patients with a better sense of uncertainty disease intervention satisfactory results. Therefore, other types such as a low level of education repeatedly hospitalized, the patients have stent implantation after CAG and the lack of support from the community should be given more attention and care.6. Researchers provide specific information to support this fully reflects the care and love of humanity nature, could excavate the patient innermost feelings the real idea, satisfied the different patient surgery period information need, enhanced the patient to nurse the work degree of satisfaction, and promoted the healthy development of nurse-patient relationship.
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