An exploration of the relationships between uncertainty, psychological distress and type of coping strategy among Chinese men after cardiac catheterization

The experience of cardiac catheterization (CC) has included feelings of uncertainty, stress, fear and anxiety in many patients. However, conflicting findings from previous research have been reported. Chinese patients who undergo CC may experience psychological distress in a different way to other cultures as a result of traditional beliefs. Moreover, little research examining the impact of CC among Hong Kong Chinese has been carried out. Therefore, the aim of the study was to explore relationships between uncertainty, psychological distress and coping strategy in Chinese men after CC, using Mishel's model of uncertainty in illness as a framework. A convenience sample of 27 men hospitalized for cardiac catheterization participated in this study using a descriptive, correlational research design. Ethical approval was obtained from the Ethics Committee of the Medical Faculty at the Chinese University of Hong Kong and from the Executive Committee of the hospital. Participation was on a voluntary basis with patient confidentiality assured. Self-report questionnaires included Chinese versions of Mishel's Uncertainty in Illness Scale (MUIS), the Profile of Mood States (POMS), the State-Trait Anxiety Inventory (STAI) and the Chinese Coping Scale (CCS) for data collection. Data were analysed using the Statistical Package for Social Sciences. High mean scores for uncertainty (mean = 1014, SD = 1149) and variables measuring psychological distress (mood disturbance mean = 36.6, SD = 33.6, state-anxiety mean = 39.1, SD = 8.95, trait-anxiety mean = 43.7, SD = 8.1) among these participants suggest that Hong Kong Chinese men experience uncertainty and psychological distress when undergoing cardiac catheterization. Strong relationships between uncertainty and mood disturbance (r = 0.57, P = 0.01), trait-anxiety and mood disturbance (r = 0.65, P = 0.01) and state-anxiety and external coping strategies (r = 0.50, P = 0.05) were found. These findings suggest that relationships between uncertainty, psychological distress and external coping strategies exist in Chinese men hospitalized for cardiac catheterization. Moreover, these findings may help nurses' design culturally specific interventions for their patients.