Study On The Influence Factors Of Uncertainty In Illness And The Effect Of The Continuous Rehabilitation Guidance In Patients With Coronary Artery Bypass Graft Surgery

Objectives(1)To analyze the level and impact factors of uncertainty in illness of patients with coronary artery bypass graft (CABG).(2)To explore the correlation between uncertainty in illness and social support of patients with coronary artery bypass graft.(3)To explore the correlation between uncertainty in illness and coping styles of patients with coronary artery bypass graft.(4)To evaluate the influence of continuous rehabilitation guidance for uncertainty in illness, social support, coping style and rehabilitation after surgery, so as to provide theoretical basis for clinical nursing workers to formulate individualized rehabilitation guidance.MethodsConvenience sampling method was used to select107objects from October2012to November2013in cardiovascular surgery department of one hospital in Tianjin. Four questionnaires were used to finish baseline survey, including general data survey scale, Mishel uncertainty in illness scale, Social Support Questionnaire, Medical copy method questionnaire, then analyze the influence factors of uncertainty in illness and the correlation with social support and coping style; Then107patients who volunteered to participate in the experimental study were divided into experimental group with51cases and control group with56cases according to the hospitalization time, there were no significant differences between two groups in treatment options and general information. The control group accepted routine nursing and health education and the experimental group accepted continuous rehabilitation guidance on the basis. Then uncertainty in illness, social support, coping style and clinical indicators were compared between two groups at discharge from hospital, one month after discharge, three months after discharge.Result(1)The uncertainty in illness of patients with CABG surgery in medium level, univariate analysis of variance showed its influence factors include:course of disease, residence, education level, mode of living, self-conscious symptom severity, family history.(2)The uncertainty in illness was negatively correlated with social support and confrontation, it was positively correlated with the avoidance and yield.(3)The multiple linear regression analysis shows that the main influence factors of uncertainty in illness were:course of disease, family history, live alone, social support, yield.(4)There were no statistical significance between the experimental group and control group with baseline dates at admission; The total score and it’s dimension of uncertainty in illness of experimental group was significantly lower than control group; the total score and it’s dimensions of social support was significantly higher than control group; the score of confrontation was significantly higher than control group; the score of yield and avoidance was significantly lower than control group; The time of postoperative care and postoperative respirator use was less than the control group; The rate of pleural effusion and pulmonary infection after surgery in experimental group was significantly lower than control group; The ejection fraction and6-MWT of experimental group was better than control group, These differences were statistically significant.ConclusionsFor higher levels of uncertainty in illness of patients with coronary artery bypass graft should cause the attention of nurse, and in clinical work we should give timely and effective assessment and guidance to patients with family history, short course of disease, live alone, and improve the patients’level of social support, guide the patients to take right way to deal with the disease; Continuous rehabilitation guidance reduce the patient’s uncertainty in illness effectively, raise the utilization of social support, encourage patients to face the disease, urge the patients to establish a kind of living style which is favorable of postoperative rehabilitation, in order to improve the patient’s heart function and exercise level, accelerated postoperative recovery process, and improve their quality of life.