初患心肌梗塞病人不確定感與焦慮反應－因應行爲效應之探討

Uncertainty and Anxiety in Patients with Initial Attack of Myocardial Infarction: The Effect of Coping Methods

10.7081/NR.200104.0159

許淑蓮(Shei-La Sheu)

不確定感 ； 因應行爲 ； 焦慮 ； 心肌梗塞 ； Uncertainty ； coping ； anxiety ； myocardial infarction

護理研究

9卷2期（2001 / 04 / 01）

159 - 171

繁體中文

心肌梗塞是一個具有生命威脅且會隨時復發的疾病，病人有許多不確定的事情要去面對及因應，而因應的好壞則影響病人的情緒狀態。本研究之目的為探討初患心肌梗塞病人于住院期間：(1)不確定感受程度及來源；(2)焦慮的程度；(3)採用的因應行為；(4)不確定感、因應行為與焦慮間的關係，及(5)因應行為對不確定感及焦慮關係的影響。本研究物件為教學醫院中50位初患心肌梗塞的病人，研究工具為疾病不確定感量表，修正後的因應行為量表及焦慮情境量表。研究結果發現初患心肌梗塞病人于住院期間有高程度不確定感受的病人只占2%，“我不知道下一步會發生什麼事”為病人感覺最不確定的事項；呈現明顯焦慮的病人有10%。平均程度介於有一眯焦慮及頗為焦慮之間；最常使用尋求社會資源的因應策略。最後本研究發現情緒導向性因應向性因應行為對複雜性不確定感及焦慮間的關係有正向效應及仲介效應，而問題導向性因應行為對不確定感及焦慮間的關係沒有任何效應。本研究結果可協助護理人員依病人個別不確定感受的差異，幫助他們使用不同因應方法，以達到最佳情緒狀態。

Myocardial infarction is a life threatening disease. Patients, especially those with a first time attack, experience a great deal of uncertainty and emotional disturbance which depend on the effectiveness of coping methods. Four questions were addressed in this study: (1) the degree and sources of uncertainty, (2) the coping methods used, (3) the degree of anxiety, (4) the relationship among uncertainty, coping methods and anxiety, and (5)the effect of coping methods on the relationship between uncertainty and coping methods. Fifty patients with first time attack in a teaching hospital participated this study. The instruments were Chinese versions of Mishel’s Uncertainty in Illness Scale, the Revised Ways of Coping Check List and Spielberger’s State Anxiety Inventory. The results showed that only 2% of patients experienced high uncertainty and 10% experienced anxiety; the average of uncertainty and anxiety were between sometimes and fairly often. “It is not clear what is going to happen to me” was the first source of uncertainty. The most often used coping method for these patients was seeking social support. Finally, the results showed that emotion-oriented coping had both positive main effect and mediating effect on the relationship between uncertainty of complexity and anxiety. The findings of this study suggest nurses should help patients utilize different coping methods, according to individual difference, in order to achieve optimal emotional state.

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