The relationship between self-management with health locus of control and copy style among coronary heart disease patients complicated with heart failure
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摘要: 目的 调查冠心病并发心力衰竭患者自我管理行为及健康心理控制源和应对方式相关性,为制定针对性的干预措施提供依据。 方法 采用便利抽样法选取2015年5月-2016年11月在温州医科大学附属第二医院住院就诊的冠心病并发心力衰竭患者152例,用自行设计的一般资料调查问卷、冠心病自我管理行为量表、多维度健康心理控制源量表C表、医学应对问卷,对其进行测量。 结果 冠心病并发心力衰竭患者自我管理得分为(58.90±10.19)分,处于中等水平,健康内部控制、健康权威人士(医生)控制、健康权威人士(其他人)控制、面对型应对与自我管理行为呈正相关关系,相关系数r分别为0.498、0.263、0.310、0.525(均P<0.05),而健康机遇控制、屈服、回避型应对与自我管理行为呈负相关,相关系数分别为-0.250、-0.248、-0.468(均P<0.05)。 结论 冠心病并发心力衰竭患者自我管理行为较差,护理人员需要充分了解患者的健康心理控制源特点,提高健康内部控制水平,提供更多的疾病康复知识,与患者建立良好的医患、护患关系;同时对应对方式进行评估,对采取消极应对方式的患者该有针对性地进行健康教育,可以侧重于告知患者知识内容,教会具体做法;对于日常生活管理和情绪控制相关的知识,除了教会患者要如何做,还应讲解行为的重要性,关注患者态度的转变,树立实施健康行为、控制病情的信心,最终提高自我管理行为。Abstract: Objective To describe the relationship between self-management with health locus of control and copy style among coronary heart disease patients complicated with heart failure and to provide a basis for the targeted interventions. Methods From May, 2015 to November, 2016, totally 152 patients were invited to complete demographic questionnaire, coronary heart disease self-managements scale, multidimensional health locus of control scale, and medical coping modes questionnaire. Results The average score of self-management was 58.90±10.19, at moderate level. IHLC, DHLC, OHLC and confronce have a positive correlation with self-management, and the correlation coefficient was 0.498, 0.263, 0.310 and 0.525 respectively (P<0.05); CHLC, avoidance and resignation have a negative correlation with self-management, and the correlation coefficient was -0.250, -0.248 and -0.468 respectively (P<0.05). Conclusion Self-management among coronary heart disease patients complicated with heart failure was not optimistic and it needs more attention. Nurses can do more targeted health education based on health locus of control and copying style, improve patients' IHLC level and provide more knowledge of disease rehabilitation to patients. They also need encourage patients to take a positive coping style and teach patients how to do and explain the importance of the behavior. Besides, nurses need to pay attention to the changes of attitude of patients, establish confidence of rehabilitation, and improve self-management behavior finally.
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Key words:
- Coronary heart disease /
- Heart failure /
- Self-management
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