BACKGROUNDThe 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, self-management behavior of coronary heart disease and quality of life after stenting.METHODSA 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 36-item Short Form Health Survey 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.RESULTSThe 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).CONCLUSIONSOverall, 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.

目的 探讨经皮冠状动脉支架植入术后老年患者疾病不确定感影响因素及护理对策.方法 采用便利抽样法,选取2021年1月—6月在复旦大学附属华东医院心血管内科行经皮冠状动脉支架植入术的老年患者168例,采用《中文版疾病不确定感量表(MUIS)》评估患者疾病不确定感影响因素.结果 文化程度、是否退休、与子女同住、支架植入数、住院期间护士指导与支持、子女/配偶给予照顾与支持、自觉症状改善程度、心绞痛发作频率、出院后有随访护士的支持等因素差异均有统计学意义(P<0.05).结论 经皮冠状动脉支架植入术后老年患者均存在中高水平的不确定感影响因素,为制定针对性、个体化和综合性的临床护理干预提供依据.