The Perceived Discomforts And The Influence Factors Of Coping Styles, Coping Ability Of Patients With Coronary Heart Disease After Percutaneous Coronary Intervention

ObjectivesTo investigate the perceived comforts in a group of patients performed with PCI for the first time due to CHD, and to explore the change of their coping strategies, styles and coping ability before and after PCI, and the influence factors of their coping styles and coping ability after PCI. It could be used as evidence for the health care providers to formulate related nursing intervention in clinical settings.MethodsSelf-control trials were conducted in this study. A consecutive series of eligible 110 patients, male 61, female 49, was recruited from a third-grade class-A hospital in Hefei, Anhui province, China after their first PCI between May,2008 and May,2009. After obtaining informed consent, patients were required to complete the questionnaire survey by JCS, SOC-13 and self-designed questionnaire about the patient's discomforts after PCI and general information questionnaire under the same direction. The data was analyzed using the SPSS17.0 statistics software.Results1.53.64% of patients experienced some forms of discomforts related to the PCI, and 67.80% of them perceived more than one sensation of discomfort.The discomforts mentioned were pain in the back (45), insomnia (39), restless (37), pain in the insertion site(36), problems with defecating/urinating(25),tingling of lower limbs(12) and problems with eating and drinking(6), and back pain and pain in the insertion site were marked as the most unbeared sensations.2. With the exception of emotive (P=0.464>0.05), the values of 7 coping styles of patients after PCI were much higher than the ones before PCI(P<0.01), and the level of patiets' coping was related to their gender (evasive,P=0.031<0.05), age (P<0.05),occupation (P<0.05), monthly income (confrontational,optimistic,supportive and palliative, P<0.05), marital status (evasive, P=0.021<0.05), modes of payment for medical expenses (supportive, P=0.020<0.05),smoke (confrontational, optimistic, supportive, self-reliant, fatalistic and palliative,P<0.05) and perceived discomforts (supportive, P=0.033<0.05), etc. The optimistic was the most commonly used coping style, and its average score was 2.59±0.98; The fatalistic was the least frequently used style, and its average score was 1.15±1.15.3. The total score of SOC or coping ability of patients after PCI was unchanged (P=0.532>0.05), compared with the one before PCI. It was related to the patients' occupation (F=10.980, P=0.000<0.01), monthly income (F=4.411, P=0.014< 0.05), smoke (F=4.027, P=0.021<0.05),severity of coronary artery (F=6.777, P=0.002<0.01) and whether or not to have the perceived discomforts (F=-4.645, P=0.000<0.01).4. There was no correlation that gender, age, education, marital status, payment mode, economic conditions, smoke, disease history, vascular lesions with the total score of SOC or coping ability of patients with CHD after PCI, while there were multiple correlation that the patient's occupation and perceived discomports with the total score of SOC or coping ability after PCI, and perceived discomports posed a most significant effect on the score of SOC orcoping ability of patients with CHD after PCI, and its regression coefficient was-0.513.Conclusion1. The majority of patients with CHD had various perceived discomforts after PCI; therefore, strengthening the postoperative nursing care and promoting patients' comfort is an important part of nursing. 2. The total coping level of patients with CHD after PCI can be remarkablely increased, with the exception of emotive coping, and there are many fators, patients'gender, age, marital status, occupation, monthly income and modes of payment for medical expenses, influencing the application of diverse coping styles of patients after PCI. So the postoperative instruction should be strengthened to encourage patients to relieve their stress by using appropriate coping methods.3. The total level of SOC or coping ability of patients with CHD after PCI was relatively stable. The perceived discomforts and patients'occupation were the major factors that influenced the coping level or coping ability of patients with CHD after PCI, and the former was the most important factor.4. We should reinforce the psychological instruction to the female patients, elderly or widowed patients, patients with low income and self-funded patients, etc, and support and care from every corner of society could also facilitate the ir effective coping.