Study On The Status And Relationship Between Attachment,Coping Style And Health Empowerment Of Elderly Patients With Cardiovascular Disease

Objective In this study,the elderly patients with cardiovascular disease were investigated by questionnaire to describe their attachment,medical coping style and health empowerment status and influencing factors,to explore the relationship between the three,and then to further understand their health empowerment status and characteristics through interview research,which would provide basis of effective ways to improve the health empowerment level of elderly patients with cardiovascular disease in hospital.Method Study 1 is the questionnaire survey of 233 eligible elderly patients with cardiovascular disease who were hospitalized in the cardiovascular group ward of a Grade 3A hospital in Shanxi Province from March to July 2019.The contents of the questionnaire mainly include: patient general situation questionnaire,The Relationship Structure Questionnaire(ECR-RSQ),Medical Coping Style Questionnaire(MCMQ),and elderly chronic disease health empowerment scale.SPSS22.0 software was used for statistical analysis.Study 2 is the health empowerment interview research,using face-to-face semi-structured interviews to collect data of 18 elderly inpatients with cardiovascular disease.An outline of the interview is presented from four dimensions: belief and attitude,knowledge and ability,action and performance,support and resources,according to the theory of health empowerment.After the interview,the data were transcribed in words and analyzed by Giorgi data analysis method.Result 1.The scores of attachment of hospitalized elderly patients with cardiovascularchronic diseases were as follows:partner attachment anxiety dimension(6.89±2.29),partner attachment avoidance dimension(19.14±6.60),children attachment anxiety dimension(7.06±2.40)and children attachment avoidance dimension(22.24±5.19).The scores of medical coping style were as follows: face dimension(16.19 ±4.14),avoidance dimension(13.63 ±2.56)and resignation dimension(9.33 ±3.50).And the total health empowerment score is(3.422±0.364).2.There were significant differences in the distribution of mate attachment types among elderly patients with different gender.In terms of coping style,place of residence,major medical decision makers entered the regression equation facing the influencing factors of dimension(P < 0.05).The regression equation of factors affecting the length of time and educational level into the avoidance dimension(P < 0.05).Regression equation of influencing factors of monthly income level entering yield dimension(P <0.05).Patients’ average monthly income,length of illness,place of residence and number of children were the influencing factors of health empowerment.3.The score of health empowerment was positively correlated with confrontation,negatively correlated with resignation,children’s attachment anxiety and avoidance dimension,and children’s attachment anxiety and avoidance dimension is negatively correlated with resignation(r=-0.426 0.525,P < 0.05).Resignation plays a partial mediating role between partner attachment anxiety and belief,support obtaining.The proportion of intermediary effect to total effect is 20.645%,19.967%.Resignation plays a partical mediating role between children’s attachment anxiety and support obtaining,self-reconstruction.The proportion of intermediary effect to total effect is20.665%and35.489%.Resignation and confrontation plays a partial mediating role between spouse attachment avoidance and support obtaining.The proportion of intermediary effect in total effect is 10.593%,11.508%.Resignation plays a partial mediating role between children’s attachment avoidance and support obtaining.The proportion of intermediary effect to total effect is 10.326%.4.Results of qualitative studies(1)belief : relative lack of confidence in disease control;and more avoidance of disease;(2)knowledge and capacity: diverse access todisease knowledge,but mixed information,poor ability to identify information,less knowledge of physical examination report and causes of disease;(3)actions and manifestations: emotions are mostly affected by disease,have ability to control diseases through lifestyle adjustments,and there is irrational drug use concepts;(4)support and resources: desired support involves medical care,communities and families.As for family’s support,they want to remain independent and fear to become a burden.They show negetive attitude to support beyong the family.Conclusion 1.The health empowerment of elderly patients with cardiovascular disease is at lower level,and the medical coping style is relatively negative,with unsafe attachment type as the main type.2.Gender affects the partner attachment of elderly patients with cardiovascular disease;residence,major medical decision makers,duration of illness,education and average monthly income are the factors influencing coping style;monthly income,duration of illness,place of residence and number of children are the factors influencing the level of health empowerment.3.Attachment,coping style and health empowerment are two-way linked,attachment style affect the health empowerment level of elderly patients through the medical coping.Health care workers and carers can improve the health empowerment by improving their attachment relationships and coping styles.4.Improving the level of patient health empowerment can be started from the following aspects: strengthening responsibility belief,providing scientific access to get disease knowledge,correcting unreasonable drug use concept,respecting patient will and providing support resources.