Study On The Status And Influencing Factors Of Health-related Quality Of Life In Patients With Myocardial Infarction

Objective:To evaluate the health-related quality of life of patients with myocardial infarction,further analyze and explore its influencing factors,and provide empirical evidence for the development of targeted interventions to improve the health-related quality of life of patients with myocardial infarction.Methods:Questionnaire survey method:Using the cluster sampling method,we selected 457patients with myocardial infarction in the cardiology department from April to October 2020in a two tertiary hospitals in Xinjiang,using the general information questionnaire,myocardial infarction multidimensional scale,medical coping style scale,and psychology Consistency scale and disease perception questionnaire were used for questionnaire surveys.Statistical analysis method:Use Epi Data3.1 double check the input data,SPSS24.0 for statistical analysis,the measurement data obey the normal distribution and use the mean±standard deviation((?)±s)to describe,the comparison between groups uses t test and analysis of variance;the measurement data does not obey The normal distribution is described by the median and interquartile range[M(Q)],and the rank sum test is used for comparison between groups.The reliability and validity of the chronic disease resource utilization questionnaire were tested and analyzed using Amos 26.0 software.The reliability was evaluated by internal reliability and split-half reliability,and the validity was evaluated by structural validity,convergent validity,and discriminative validity;Multivariate linear regression was used to analyze the influencing factors of health-related quality of life in patients with myocardial infarction.Use the model test in the SPSS Process macro plug-in and stepwise test regression analysis to explore the mediating effect of medical coping styles.Results:1.The total score of myocardial infarction multidimensional scale for patients with myocardial infarction is(84.96±21.78)points.The top three scores are physical activity(32.84±8.70)points,diet(7.78±3.03)points and emotional response(10.25±3.46))Points;the chronic disease resource utilization score of patients with myocardial infarction is(48.60±10.78)points,the psychological consistency score is(64.39±10.68)points,the medical coping style score is(38.57±6.57)points,and the disease perception score is(43.46±9.12))Minute;2.Correlation analysis:The score of myocardial infarction multidimensional scale in patients with myocardial infarction is positively correlated with the score of disease perception(r=0.400,P<0.001)and the score of medical coping style(r=0.385,P<0.001),and the score of chronic disease resource utilization(r=-0.180,P<0.001)and the psychological agreement score(r=-0.410,P<0.001)were negatively correlated,and the differences were statistically significant(P<0.001);single factor analysis:gender,employment,Medical payment method,age,per capita household income,main caregivers,smoking,drinking,whether there is a history of angina pectoris,previous hospitalization days,cardiac function classification,number of other diseases combined,C-reactive protein,lactate dehydrogenase Comparison of the total scores of health-related quality of life such as creatine kinase isoenzyme,etc,the difference was statistically significant(P<0.05);3.Reliability and validity test of the Chinese version of chronic disease resource utilization survey scale:(1)Reliability:(1)Cronbach’sαcoefficient is 0.813,and Cronbach’sαcoefficient of each dimension is between 0.660 and 0.973.(2)The split-half reliability of the total table is 0.738,and the split-half reliability of each dimension is 0.537～0.966.(2)Validity:(1)Structural validity:Exploratory factor analysis extracts 7 common factors with characteristic values>1,and the cumulative variance contribution rate reaches 70.474%;the confirmatory factor analysis results are:χ~2/df=2.357<3,RMSEA=0.074<0.08,GFI=0.871,CFI=0.883,AGFI=0.826.(2)Convergent validity:The AVE value of each latent variable is between 0.386 and 0.840,and the combined reliability CR is greater than 0.600.(3)Distinguishing validity:There is a significant correlation among the 7 dimensions(P<0.001),the absolute value of the correlation coefficient is all<0.5,and all are less than the corresponding square root of AVE.4.Multiple linear regression analysis showed that:female(β=0.139,P<0.001),heart function grade IV(β=0.118,P=0.001),and the location of myocardial infarction was the posterior wall(β=0.084,P=0.017),Coping style avoidance(β=0.098,P=0.008)and yield(β=0.215,P<0.001)dimensions,disease perception(β=0.216,P<0.001)negatively affect the health-related quality of life of patients with myocardial infarction;psychological consistency Medium intelligibility(β=-0.128,P=0.009)and controllability(β=-0.113,P=0.021)dimensions,chronic disease resource utilization TCM team(β=-0.110,P=0.004),family and friends(β=-0.075,P=0.037)and personal coping(β=-0.094,P=0.022)dimensions positively affect the health-related quality of life of patients with myocardial infarction,and the total variation of the dependent variables can be explained by the independent variables in the regression model accounting for 46.3%.5.Chronic disease resource utilization scores are negatively correlated with myocardial infarction multidimensional scale scores(r=-0.116,P=0.026),and are positively correlated with medical coping style scores(r=0.281,P<0.001);myocardial infarction multidimensional scale scores The score was positively correlated with the score of medical coping style(r=0.326,P<0.001).The results of the SPSS Process macro plug-in show that the medical coping style has a completely mediating effect between chronic disease resource utilization and health-related quality of life,and the mediating effect accounts for 62.41%of the total;6.The SPSS stepwise test regression analysis method shows that the mediating variable"medical coping style"has a partial mediating effect between the independent variable"psychological coherence of patients with myocardial infarction"and the dependent variable"health-related quality of life",and the mediating effect has a significant effect on the overall effect.The effect accounted for 22.70%.Among them,the multiple linear regression results also show that the mediating effect of the"face"dimension has the largest contribution rate to the total effect of 37.55%,followed by the"avoidance"and"yield"dimensions,and the contribution rates to the total effect are 7.28%and 1.46%respectively;Conclusion:1.The health-related quality of life of patients with myocardial infarction is not optimistic.The top three are physical activity,diet,and emotional response,which need to be improved.Medical staff should pay attention to the effective assessment of patients’early health-related quality of life and intervene as early as possible to effectively help patients improve their health-related quality of life;2.The chronic disease resource utilization questionnaire after reliability and validity test can be applied to patients with myocardial infarction.3.The intelligible and controllable dimensions of psychological coherence,medical staff,family and friends,personal coping dimensions,female,cardiac function classification,the location of myocardial infarction,medical coping style,and the degree of disease perception affect the heart.According to the factors affecting the health-related quality of life of patients with myocardial infarction,medical staff can make targeted intervention programs based on the above-mentioned factors to better improve the health-related quality of life of patients with myocardial infarction.4.Medical coping styles play a complete mediating role between the utilization of chronic disease resources and health-related quality of life,and partly mediate between psychological coherence and health-related quality of life.5.The results of this study provide a theoretical reference for the role of medical coping styles in promoting health-related quality of life.Medical staff can intervene in three aspects of coping styles,and at the same time,they should effectively evaluate the coping styles of patients with myocardial infarction and implement individualization.Intervention to improve their health-related quality of life.