The Effect Of Patient Empowerment On Uncertainty In Illness And Efficacy In Patients With Gastroesophageal Reflux Disease

Background:Gastroesophageal reflux disease (GERD) is a chronic disease caused by the context of stomach refluxing to esophagus, including condiscomfort or complications, the predominant being heartburn and acid regurgitation. The patient’s quality of life and daily life is seriously affected by diverse clinical symptoms and easy recurrence.Uncertainty in illness refers to a lack of ability to determine disease-related things. Mishel believed that when individuals can’t build or classify,cannot give meaning to objects or events clearly,effectively due to lack of enough clues, and can’t predict the outcome, the uncertainty in illness can produce. Once producing, uncertainty in illness can cause many adverse effects on patients. The patient’s exorbitant uncertainty in illness can cause the degradation and treatment of behavior disruptions and affect the treatment and prognosis of patients. A lot of research has focused on cancer patients at home and abroad, and other related research on chronic diseases is less.Patient empowerment helps patients to detect and develop the inherent ability of self management responsibility. Patient empowerment can help patients with chronic diseases to improve the ability of self management by changing behavior actively,so as to promote their health. At present, many studies to peritoneal dialysis patients, patients with diabetes for authorization education has been preliminary researched, and achieved good results. But patient empowerment on gastroesophageal reflux disease has not yet been researched. This study was to investigate the level of uncertainty in illness in patients with gastroesphageal reflux disease(GERD) and analyze its influencing factors in order to provide theoretical basis for the establishment of patient empowerment on GERD. On the basis of the research, patients with GERD was interved by patient empowerment to to evaluate the effect of patient empowerment on uncertainty in illness, clinical symptoms, mentality,the level of self-management and self-efficacy in patients with GERD. The study was to evaluate the effect of patient empowerment on uncertainty in illness and efficacy in patients with gastroesophageal reflux disease.Objectives:1. To investigate the level of uncertainty in illness in patients with gastroesphageal reflux disease(GERD) and analyze its influencing factors.2. To evaluate the effect of patient empowerment on uncertainty in illness and efficacy (clinical symptoms, mentality,the level of self-management and self-efficacy) in patients with gastroesophageal reflux disease.Materials and Methods:1.A total of165GERD patients were investigated with the general information, Mishel Uncertainty in illness sale(MUIS)(Chinese version), Self-Management Behavior Scale for GERD and Self-eficacy Scale for Managing Chronic Disease, the Medical Coping Modes Questionnaire(MCMQ), Zung Self-Rating Anxiety Scale(SAS) and Self-Rating Depression Scale(SDS).2. A total of124GERD patients were divided into two group(62) by random number table. The intervention group(n=62)received patient empowerment based on routine nursing care whilst the control group(n=62)received general management.Results:1.The average score of uncertainty in illness in patients with GERD was105.92±9.34at the middle level (74.8-117.4分). The scores of the factors in uncertainty in illness were, from high to low, unpredictability(4.39±0.64), ambiguity(3.50±0.31), inconsistency(3.10±0.44), complexity (3.09±0.44).2.Course, educational level and anxiety level were significant predictors of uncertainty in illness in patients with GERD.3. After3months, the score of uncertainty in illness, clinical symptoms and anxiety in patients with gastroesophageal reflux disease in the intervention group were significantly lower than those in the control group (p<0.05);and the levels of self-management behaviors and self-efficacy in the intervention group were significantly better than those of the control group(P<0.05).Conclusions:1. The level of uncertainty in illness in patients with GERD was at the middle level.The scores of’unpredictability’uncertainty was the highest.2. Course educational level and anxiety level can affect uncertainty in illness in patients with GERD.3.The patient empowerment can lower the levels of uncertainty in illness, relive clinical symptoms, reduce the anxiety level,improve the level of self-management and self-efficacy in patients with gastroesophageal reflux disease,thus improve the curative effect.