Influence Of Stress Perception And Coping Style On Sleep Quality In Young And Middle-aged Patients With Coronary Heart Disease And Analysis Of Its Pathways

BackgroundCoronary heart disease(CHD)brings heavy burden to family and society because of morbidity,disability rate and high mortality rate.With the change of life and behavior style and the increase of social competitive pressure,the age of onset of CHD in China is becoming younger.Middle-aged and young people are the backbone of the family and society,perceived stress can cause mental stress and even sleep disorders in the middle-aged and young people,leading to CHD,which will further aggravate their mental stress and sleep disorders,forming a vicious circle.It is very significant for the recovery of physical and mental functions to take appropriate coping methods and reduce the stress response of patients to stress.ObjectivesTo investigate the status and influencing factors of perceived stress,coping style and sleep quality in young and middle-aged patients with CHD,to analyze the effect of perceived stress,coping style on sleep quality of young and middle-aged patients with CHD,to investigate the mediating effect of coping style on perceived stress and sleep quality in young and middle-aged patients with CHD,to provide guidance for medical staff to carry out feasible health promotion work,and to provide reference for the development of psychological intervention strategies.MethodsA total of 250 young and middle-aged patients with coronary heart disease(CHD)who were admitted to the department of cardiology in five grade A hospitals in northern Henan from August 2019 to July 2020 were selected as the survey subjects by convenience sampling method.Questionnaire on general information of young and middle-aged patients with CHD,medical coping modes questionnaire(MCMQ),chinese perceived stress scale(CPSS)and pittsburgh sleep quality index(PSQI)were used to investigate the patients.SPSS26.0 software was used to conduct independent sample t test,univariate ANOVA test,bivariate Pearson correlation analysis,and multivariate linear stepwise and stratified regression analysis in regression analysis.AMOS22.0 software was used to construct a mediating effect model guided by the influence path of perceived stress and coping style on sleep quality of middle-aged and young patients with CHD,and Bootstrap method was used to test the mediation effect of coping styles,a=0.05 was used as the test level.Results1.The score of perceived stress in young and middle-aged patients with CHD was(30.71±7.39)points,and the score of tension dimension was higher.The score of coping dimension was(18.11±3.93),lower than the norm of 701 chronic disease patients measured by domestic scholars,the score of avoidance dimension was(16.36±2.76),and the score of surrender dimension was(9.86±3.10),both higher than the above normal.The total score of PSQI in young and middle-aged CHD patients was(7.44±3.60),and Sleep disorders were detected in 102 patients.2.The influencing factors of perceived stress in young and middle-aged patients with CHD were confidence in the treatment of the disease,working status,first hospitalization due to CHD,educational level,and stent implantation(P<0.05).Work status,smoking,course of disease,educational level and marital status were the influencing factors of coping styles in young and middle-aged patients with CHD(P<0.05).Cost payment method,number of complications and marital status were the influential factors of avoidance coping style in young and middle-aged patients with CHD(P<0.05).First hospitalization due to CHD,working status,confidence in the treatment of the disease,and interventional stent were the influencing factors of the yield coping style of young and middle-aged patients with CHD(P<0.05).The influencing factors of sleep quality in young and middle-aged patients with CHD were the number of complications,working status,the number of blood vessels involved,confidence in the treatment of disease,and smoking(P<0.05).3.Perceived stress was negatively correlated with confrontation(P<0.01),positively correlated with avoidance coping and yield coping(P<0.01),and negatively correlated with sleep quality(P<0.01)in young and middle-aged CHD patients.Confrontation was positively correlated with sleep quality scores(P<0.01),avoidance and surrender coping were negatively correlated with sleep quality scores(P<0.01).4.Perceived stress and coping style are the influencing factors of sleep quality in young and middle-aged patients with CHD.The mediating effect model showed that perceived stress can directly predict which coping style patients are more inclined to choose,confront coping has a direct positive effect on patients’ sleep quality,while avoidance and submission have a direct negative effect on patients’ sleep quality.Perceived stress can directly and negatively affect sleep quality,perceived stress can also indirectly affect sleep quality through the mediating effect of different coping styles,with a mediating effect of 0.321,accounting for 46.32% of the total effect.Conclusions1.The perceived stress level of middle-aged and young patients with CHD was higher,compared with the norm of domestic patients,the response attitude was more negative,and the sleep quality was poor.2.Different demographic and sociological factors and disease-related factors have different effects on the perceived pressure,coping style and sleep quality of young and middle-aged patients with CHD.3.Perceived stress and coping style are the influencing factors of sleep quality in young and middle-aged patients with CHD,coping styles played a partial mediating role in the relationship between perceived stress and sleep quality in young and middle-aged patients with CHD.