The Relevant Research Among Chronic Illness Resources,Illness Perceptions,Sense Of Coherence,and Self-management Behavior In Patients With Lumbar Disc Herniation

ObjectiveTo Investigate the general situation of patients with lumbar disc herniation and understand the status of chronic disease resources,illness perception,sense of coherence and self-management behavior.To explore the influencing factors of self-management behavior.To clarify the correlation between the four variables.To explore the mediating effect of sense of coherence between chronic illness resources,illness perception and self-management behavior.MethodsDuring July to October 2019,400 patients with lumbar disc herniation who met the inclusion criteria were selected as the research objects and sent out questionnaires from outpatient and inpatient of Spine department of Grade A tertiary hospital in Tianjin.The questionnaires include: the General Information questionnaires,Chronic Illness Resources Survey scale(CIRS),Brief Illness Perception Questionnaire(B-IPQ),Sense of Coherence-13(SOC-13),Chronic disease self-management behavior measuring scale(CDSMBMS).SPSS 24.0 software was used for t-test,one-way ANOVA,multiple stepwise regression analysis,Pearson correlation analysis.Amos 23.0 software was used to explore the mediating effect of Sense of Coherence.Results(1)The mean score of CIRS was(57.77 ± 6.0);The mean score of B-IPQ was(44.58 ±4.19);The mean score of SOC was(62.45 ± 8.21).The score of self-management behaviors was(27.4 ± 7.04).(2)Multiple stepwise regression analysis showed that the gender,age,education level,average monthly income of the family,course of disease,degree of pain entered the regression equation,which could explain 29.7% of the variation.(3)Correlation analyze showed that the CIRS of lumbar disc herniation patients was positively correlated with the SOC(P < 0.01),negatively correlated with illness perception(P< 0.01),positively correlated with self-management behavior(P < 0.01).The SOC was negatively correlated with illness perception(P < 0.01),positively correlated withself-management behavior(P < 0.01).The illness perception was negatively correlated with self-management behavior(P < 0.01).(4)Structural equation model showed that sense of coherence played a part of mediating role in the CIRS and self-management behavior,and the proportion of mediating effect was47.94%.Meanwhile,it also played a part of mediating role in illness perception and selfmanagement behavior,and the proportion of mediating effect was 40.25%.Conclusions(1)The utilization of chronic illness resources in LDH patients was ideal;The illness perception was at a middle level;The sense of coherence was at a moderate level.Besides,the self-management behavior was low.(2)The influencing factors of self-management behavior with LDH patients included the gender,age,education level,average monthly income of the family,course of disease,degree of pain.(3)There is a correlation between chronic illness resource utilization,illness perception,sense of coherence and self-management behavior in LDH patients.LDH patients had higher level of resources utilization and sense of coherence,lower level of illness perception,tend to higher self-management behavior.(4)The sense of coherence of patients with LDH patients played a part in mediating between resources utilization and self-management behavior,as well as between illness perception and self-management behavior.