Illness uncertainty and its associated factors in coronary heart disease patients with heart stent implantation: a cross-sectional study

Abstract

Background: The purpose of this study was to investigate the illness uncertainty and its influencing factors in patients after heart stent implantation, and to explore the relationship between uncertainty of disease, selfmanagement behavior of coronary heart disease and quality of life after stenting. Methods:A cross-sectional study of 168 patients with cardiac stent implantation on illness uncertainty in a tertiary hospital in Shanghai. The General Information Questionnaire and the Mishel's Uncertainty in Illness Scale (MUIS) was used to measure the uncertainty of disease in patients after coronary stenting, and the Coronary Self-Management Scale (CSMS) and Quality of Life Scale (SF-36) were collected, using Pearson's method for correlation analysis. The indicators with significant statistical differences in univariate analysis were included, and the factors affecting patients' perception of disease uncertainty were analyzed by stepwise regression fitting multiple linear regression equations. Results:The study showed that the mean score for disease uncertainty was 79.83±14.05 out of 160 points.By the multiple stepwise linear regression analysis, the results showed that subjective symptom improvement, follow-up with nurses after discharge, care and support from family members after discharge, quality of the quantity of stents, guidance and support from nurses during hospitalization, and educational level had a significant impact on the total uncertainty score, and were the most important factor of patient illness uncertainty. In patients with coronary heart disease, uncertainty was moderately negatively correlated with self-management ability (P<0.05, r=−0.636), and highly negatively correlated with overall quality of life scores (P<0.05, r=−0.857).Conclusions: Overall, patients with coronary stents had moderate disease uncertainty, suggesting that uncertainty is common among patients after cardiac stenting. In order to improve the uncertainty of disease in patients after with heart stent implantation, (especially for patients with a large number of implanted stents), family members should give sufficient care; doctors and nurses should provide patients with adequate health education, assist patients in establishing healthy behaviors, and strengthen its self-management ability, thereby reducing the patient's sense of uncertainty, thereby improving the long-term prognosis and the patient's quality of life.

Impact of specialized nursing outpatient case management on post-coronary artery bypass grafting patients

“…This indicated that specialized nursing outpatient case management can effectively alleviate patients' adverse emotions. The reason behind this may be attributed to the detailed information collection and assessment of each patient, the development of personalized care plans tailored to individual needs and circumstances, and the better fulfillment of patients' psychological and emotional needs, thus alleviating adverse emotions[ 23 - 25 ]. Additionally, specialized nursing outpatient nurses help patients better understand and cope with postoperative emotional changes by providing relevant health education and psychological support.…”

Care intervention on psychological outcomes among patients admitted to intensive care unit: an umbrella review of systematic reviews and meta-analyses

“…When patients and their families cannot understand the information provided by ICU physicians or get less information, their uncertainty would increase, which would further cause them anxiety. Research showed that uncertainty accounted for 30.2% of the factors that cause family members’ transfer anxiety, and providing information was a key factor in reducing uncertainty and anxiety [ 52 , 53 ].…”

Care intervention on psychological outcomes among patients admitted to intensive care unit: an umbrella review of systematic reviews and meta-analyses

“…When patients and their families could not understand the information provided from ICU physicians or get less information, their uncertainty would increase, which would further cause them anxiety. Researches showed that the uncertainty accounted for 30.2% of the factors that cause family members' transfer anxiety, and providing information was a key factor in reducing uncertainty and anxiety [38,39]. Preoperative education was also helpful to improve the prognosis of patients undergoing cardiac surgery [31] because it may enhance patients' knowledge; besides, meeting their information needs could also mitigate their distress [40].…”