[Uncertainty and anxiety in patients with initial attack of myocardial infarction: the effect of coping methods]

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.