Study On Loss Degree Of Healthy Functions In Hospitalized Patients With Coronary Heart Disease And Nursing Coping Strategy

ObjectiveThis research is to understand the status of loss degree of healthy functions and family care in hospitalized patients with coronary heart disease (CHD);To explore the Multi-dimensional relationships between loss degree of healthy functions,age,heart function,family care and other influencing factors.Assessment the nursing needs of CHD patients combining with the qualitative research to develop nursing intervention.MethodsChoosing department of cardiology of Huaihe hospital affiliated to Henan university hospitalized patients with CHD between December 2009 and May 2010 as participants, using quantitative research combined qualitative research methods.A questionnaire study including①general information and disease data of patients②Measure of loss degree of healthy functions: Using Sickness impact profile to measure function loss which are caused by disease③Measure of family care: Using Family APGAR index to assessment adoption partnership, growth, affection, reslove five dimensions of family function.Using phenomenologic method ,combining literature to draw up interview outline based on Maslow's hierarchy of needs. After obtaining patients'agree, the interview can be conducted by observing, recording and noting. 182 valid questionnaires were received through face-to-face investigating , response rate is 100%,and there were 30 patients brought into qualitative research. SPSS11.5 software was used for data processing. The statistical methods include :t test,variance analysis,rank sum test, pearson correlation analysis, multi-factor logistic regression model, etc.Results 1.The loss degree of healthy functions status of hospitalized patients with CHD182 patients have a total loss score of 25.285±8.577;Recreation an pastime loss score of 57.187±14.339;Sleep rest loss score of 30.330±16.456;Home management loss score of 13.115±5.441;Eating loss score of 28.286±9.596;Social-psychological loss score of 32.188±14.619;it is include:Emotional behaviour loss score of 49.192±19.744;Social interaction loss score of 30.368±12.519;Communication loss score of 6.992±8.608;Alertness behaviour loss score of 25.300±14.161;Physical loss score of 18.925±10.203;it is include:Mobility loss score of 14.110±10.804; Ambulation loss score of 22.122±11.500;Body care and movement loss score of 28.594±12.923.2.The relationship between individual characters and loss degree of healthy functionsThe functional losses showed significant differences among patients of different genders, ages,education levels,incomes, residences, nursing satisfactions,times of hospitalization, heart functions, degrees of disease(P<0.05).3.The family care status of hospitalized patients with CHD182 patients have a total family care score of 25.285±8.577; The patients of family function fine accounts for 47.2%, medium of family dysfunction accounts for29.1%,severity of family dysfunction accounts for 18.1%.Among the five dimensions of the family care, they were sorted by care level as follows :adoption, partnership, growth, affection, resolve.4.The relationship between loss degree of healthy functions and family careThe correlation analysis showed, loss degree of healthy functions and family care were negatively related ( r=-0.355, P < 0.05 ) .Variance analysis indicated:the functional losses of total health, social-psychological, sleep rest dimensions showed significant differences among patients of different family cares(P<0.05), Patients with family function fine have highest loss degree of healthy functions level, patients with severity of family function have lowest loss degree of healthy functions level, and patients with medium of family function have moderate level.5 .Multiple factor regression analysis of loss degree of healthy functionMultiple factor regression analysis showed: age ,heart function, degree of disease are risk factors for total healthy function,family care are protect factors.The OR values respectively are 1.278,10.839,25.874,0.380;gender, age, heart function are risk factors for physical function, residence, family care are protect factors .The OR values respectively are 4.776,1.494,28.012,0.020,0.380; age, times of hospitalization are risk factors for social-psychological function,incomes,nursing skill satisfactions,family care are protect factors.The OR values respectively are 1.097,1.163,0.269,0.230,0.480.6.The nursing needs of hospitalized patients with CHDThe five levels of nursing needs is diverse in the hospitalized patients with CHD, the older the age ,the high demands of physiological and safety needs they get;The female patients had higher demands of treatment safety than male patients;The lower level of education and income they have, the demands are more wider of the safety,Love and belongingness needs; The higher level of education and income they have, the self-esteem and self-actualization needs are more strong; Family care is closely related to nursing needs, patients with family function fine have lower demands on lower level of nursing needs especially on love and belongingness needs and they get a higher demands on self-actualization needs.Conclusions1.Every dimension of healthy functions declined in hospitalized patients with CHD,Every dimension that measure the patients'functional loss values from high to low in order are: emotional behaviour,sleep rest, social interaction, home management, mobility ,alertness behaviour, ambulation, body care and movement, eating,communication.The loss degree of social-psychological functional score is higher than the loss degree of physical functional score.2.The family care status of hospitalized patients with CHD is not optimistic.3.The main factors of the loss degree of healthy function are age, heart function, degree of disease, family care. The family care was negative correlation with the loss degree of healthy functions.The higher family care,the lower loss degree of healthy functions.4. Nursing needs and nursing satisfaction are impacted by family care of hospitalized patients with CHD,which are showed:the lower family care of patients,the higher degree of nursing needs,the lower nursing satisfaction.