불쾌 증상 이론을 적용한 심방 세동 환자의 자가관리

Self-care in Patients with Atrial Fibrillation Based on the Theory of Unpleasant Symptoms

Purpose: This study aimed to identify the relationships among disease severity, anxiety, depression, social support, unpleasant symptoms and self-care among patients with atrial fibrillation based on the unpleasant symptom theory, and to examine the mediating effects of unpleasant symptoms. Methods: A cross-sectional study was conducted. The participants were 216 patients with atrial fibrillation who were being followed up on an outpatient basis at a university hospital in Seoul. Data were collected from November 1, 2020 to June 30, 2021, using self-report questionnaires. Data were analyzed using IBM SPSS/WIN 27.0 and PROCESS macro with 95% bias-corrected bootstrap confidence interval(CI). Results: The average age of participants in this study was 66.0years. Disease severity (&#x03B2;=10.19, p<.001) and depression (&#x03B2;=1.53, p<.001) had significant positive relationships with unpleasant symptoms. Also, unpleasant symptoms (&#x03B2;=-0.03, p=.006) had a negative relationship with physical activity, which is a subscale of self- care. Social support (&#x03B2;=0.06, p<.001) was positively related with physical activity. Unpleasant symptoms showed a mediation effect in the relationship between disease severity and physical activity (Bias corrected bootstrap CI -0.65, -0.04). Depression had an indirect effect on physical activity that was mediated by unpleasant symptoms (Bias corrected bootstrap CI -0.11, -0.00). Conclusion: The findings of this study suggest that integrated strategies including physical, psychological, and social factors should be considered to promote self-care in patients with atrial fibrillation.