【摘要】：目的： 探明慢性病患者疾病不確定感的狀況及水平，發(fā)現(xiàn)影響患者疾病不確定感的因素,確認慢性病患者應對方式和社會支持的狀況,探討慢性病患者疾病不確定感與應對方式、社會支持的相關性。 方法： 本研究便利選取2013年3月～8月在蚌埠醫(yī)學院第一附屬醫(yī)院、阜陽市人民醫(yī)院住院治療的慢性病患者380例，進行問卷調(diào)查。問卷由自擬的一般人口學及相關資料問卷、中文版疾病不確定感量表(MUIS)、醫(yī)學應對問卷(MCMQ)和社會支持評定量表（SSRS）組成。應用SPSS17.0統(tǒng)計軟件進行數(shù)據(jù)分析,研究所采用的統(tǒng)計方法包括描述性分析、t檢驗或方差分析、Pearson相關性分析和多重線性回歸分析。 結(jié)果： 1.慢性病患者疾病不確定感的得分為（91.87±11.008），處于中等水平，其中平均得分最高的為不可預測維度，，其次為不明確維度。 2.不同居住地、職業(yè)、文化程度、家庭月收入、性格類型、病程和自覺疾病嚴重程度組的疾病不確定感得分差異均有統(tǒng)計學意義(P0.05)，而不同年齡、性別、婚姻狀況、民族、宗教信仰、支付方式組的疾病不確定感得分差異未發(fā)現(xiàn)有統(tǒng)計學意義(P0.05)。 3.回歸分析表明：文化程度、家庭月收入、病程、性格類型和自覺疾病嚴重程度這五個變量是影響患者疾病不確定感水平的主要因素,聯(lián)合解釋了18.4%的變異。 4.應對方式中“屈服”維度的得分為（2.12±0.62）高于國內(nèi)常模,且差異有統(tǒng)計學意義(P0.01)。 5.慢性病患者疾病不確定感總分與應對方式中的“面對”維度呈負相關(P0.05),與“屈服”維度呈正相關(P0.01)；不明確維度與“面對”維度呈負相關(P0.05),與“屈服”維度呈正相關(P0.05)；信息缺乏維度與“回避”維度、“屈服”維度呈正相關(P0.05),不可預測維度與“屈服”維度呈正相關(P0.01)。 6.患者社會支持總分為（37.68±6.30）高于一般人群社會支持平均分，且差異有統(tǒng)計學意義(P0.01)，疾病不確定感與社會支持呈負相關(r-0.155,P0.01)。 結(jié)論： 1.疾病不確定感在慢性病患者中普遍存在，且多數(shù)患者處于中等水平。 2.文化程度、家庭月收入、病程、性格類型和自覺疾病嚴重程度是慢性病患者疾病不確定感主要影響因素。 3.疾病不確定感水平與應對方式密切相關,指導其多采取有效的應對方式，可以顯著的降低疾病不確定感。 4.與一般人群比較，慢性病患者有較高的社會支持，且社會支持高者，疾病不確定感的程度低，反之則高。
[Abstract]:Objective: to investigate the status and level of disease uncertainty in patients with chronic diseases, to find out the factors influencing the uncertainty of disease, and to confirm the coping style and social support of patients with chronic diseases. To explore the correlation between uncertainty and coping style and social support in patients with chronic diseases. Methods: from March to August 2013, 380 patients with chronic diseases who were hospitalized in the first affiliated Hospital of Bengbu Medical College and Fuyang people's Hospital were investigated by questionnaire. The questionnaire was composed of self-designed general demography and related data questionnaire, (MUIS), Medical coping questionnaire (MCMQ) and Social support rating scale (SSRS) in Chinese version. The statistical methods used in the study include descriptive analysis, t-test or variance analysis, Pearson correlation analysis and multiple linear regression analysis. Results: 1. The score of disease uncertainty in chronic disease patients was (91.87 鹵11.008), which was at the middle level, with the highest score being the unpredictable dimension, followed by the uncertain dimension (2.2). There were significant differences in the scores of uncertainty of disease among groups of different residence, occupation, education, family income, personality type, course of disease and severity of conscious disease (P0.05), but different age, sex, marital status, nationality, There was no significant difference in the scores of disease uncertainty in religious belief and payment group (P0.05). The regression analysis showed that the five variables, such as education level, family monthly income, course of disease, personality type and severity of conscious disease, were the main factors affecting the patients' disease uncertainty, and the variation was 18.4%. The score of "yield" dimension in coping style was (2.12 鹵0.62) higher than that in domestic norm, and the difference was statistically significant (P0.01). The total score of disease uncertainty was negatively correlated with "face" dimension in coping style (P0.05), positively with "yield" dimension (P0.01), negatively with "face" dimension (P0.05), and positively with "yield" dimension (P0.05). The information deficiency dimension was positively correlated with the "avoidance" dimension and the "yield" dimension (P0.05), while the unpredictable dimension was positively correlated with the "yield" dimension (P0.01). The total score of social support in patients was (37.68 鹵6.30) higher than that in the general population, and the difference was statistically significant (P0.01). There was a negative correlation between disease uncertainty and social support (r -0.155, P 0.01). Conclusion: 1. Disease uncertainty is common among people with chronic diseases, and most patients are at moderate levels. 2. 2. Education level, monthly income of family, course of disease, personality type and severity of conscious disease are the main influencing factors of disease uncertainty in patients with chronic diseases. The level of disease uncertainty is closely related to coping style. Guiding them to adopt effective coping styles can significantly reduce disease uncertainty. 4. Compared with the general population, the patients with chronic diseases have higher social support, and the degree of disease uncertainty is lower in the patients with higher social support, but higher on the contrary.
【學位授予單位】：蚌埠醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R473

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