| Objective:(1)To preliminarily understand the status and influencing factors of subjective well-being(SWB)in elderly patients with coronary heart disease;(2)A structural equation model was established to explore the influencing mechanism of loneliness,self-perception of aging and perceived control on SWB of elderly patients with coronary heart disease,and to determine the effect pathway and intensity of each influencing factor on subjective well-being of elderly patients with coronary heart disease in the model,so as to provide evidence support for clinical medical staff to develop interventions to improve subjective well-being in elderly CHD patients.Methods:A total of 259 elderly patients with coronary heart disease were investigated using the general Information Questionnaire,UCLA Loneliness Scale III,the Brief Aging Perceptions Questionnaire,Control Attitudes Scale-Revised and Memorial University of Newfoundland Scale of Happiness.SPSS23.0 was used for statistical analysis of the data collected.Single factor analysis,correlation analysis and multiple stepwise regression analysis were used to explore the influencing factors of SWB in elderly patients with coronary heart disease.AMOS23.0 was used to construct and verify the structural equation model of influencing factors of subjective well-being in elderly patients with coronary heart disease.Results:(1)The subjective well-being score of elderly patients with coronary heart disease was(32.22±8.12)points,including positive emotion(7.62±1.71)points,negative emotion(5.12±3.30)points,general positive experience(10.48±2.63)points and general negative experience(4.77±3.87)points.On the basis of the relevant criteria,the scores of subjective well-being were grouped into 98 patients with high level of subjective well-being(37.8%),158 patients with medium level(61.0%),and 3 patients with low level of subjective well-being(1.2%).(2)The loneliness score of elderly patients with coronary heart disease was(35.24±6.52).(3)The total score of self-perception of aging in elderly patients with coronary heart disease was(39.59±12.83).The scores of negative outcome and control dimension were(13.49±4.62)points,positive outcome dimension(6.12±2.71)points,chronic time dimension(8.81±4.48)points,positive control dimension(4.52±2.12)points and affective representation dimension(6.58±3.25)points.(4)The score of perceived control of elderly patients with coronary heart disease was(26.54±6.81).Among them,self-efficacy(10.63±2.90)points,psychological control source)(9.35±3.21)points and the sense of powerlessness in the face of disease(learned helplessness)(6.56±2.454)points.(5)Univariate analysis showed that the subjective well-being of elderly patients with coronary heart diseases had statistically significant differences in gender,age,occupation,education,marital status,place of residence,living condition,form of medical expenses payment,economic status,family history,sleep,course of disease,number of complications and previous hospitalizations due to coronary heart disease(P<0.05).(6)Correlation analysis showed that subjective well-being was negatively correlated with loneliness and self-perception of aging in elderly patients with coronary heart disease(r=-0.684,r=-0.708,P<0.01).It was positively correlated with perceived control(r=0.702,P<0.01).(7)Multiple stepwise regression analysis showed that loneliness,perceived control,self-perception of aging,and the number of complications could all predict the level of subjective well-being of elderly patients with coronary heart disease(F=147.758,P<0.001,adjusted R~2=0.695).(8)Structural equation model showed that the model based on activity theory,cognitive adaptation theory and literature review was well fitted,X~2/df=1.667,GFI=0.951,AGFI=0.918,RMSEA=0.051,NFI=0.932,RFI=0.902,IFI=0.972,CFI=0.971,TLI=0.958,all indicators reached the standard.The total effect of loneliness on subjective well-being was-0.147,of which the direct effect was-0.047,and the indirect effect through self-perception of aging and perceived control was-0.100.Conclusions:The subjective well-being of elderly patients with coronary heart disease was in medium level.Loneliness,self-perception of aging,perceived control and the number of complications were the factors influencing subjective well-being.Loneliness not only can directly affect subjective well-being,but also indirectly affect subjective well-being through self-perception of aging and perceived control.Self-perception of aging and perceived control were mediating variables between loneliness and subjective well-being.It is suggested that medical staff should intervene in patients’psychological problems,make patients maintain a positive aging attitude,and improve their disease control beliefs so as to improve the happiness level of patients. |
PDF Full Text Request