Characterization and factors influencing the uncertainty of intolerable in older adults with multimorbidity: A Cross-sectional study.

Background: Multiple co-morbidities of chronic diseases tend to increase patients' medical costs and psychological stress, and reduce their quality of life. However, few studies have examined the mental health of older adults from cognitive perspectives and chronic disease co-morbidities.

Objectives: The aim is to investigate the current status of intolerable uncertainty and the factors that influence it in elderly patients with chronic comorbidities.

Design: Cross-sectional study design.

Settings: Departments of Gastroenterology, Endocrinology, Cardiovascular Medicine, and Respiratory Medicine, a tertiary hospital in Henan Province, China.

Participants: Elderly patients with chronic co-morbidities hospitalized in the departments of gastroenterology, endocrinology, cardiovascular medicine and respiratory medicine.

Methods: A non-probability convenient sampling method was used to select 295 elderly chronic disease co-morbid patients who were hospitalized in a tertiary-level hospital in Henan Province from June 2023 to December 2023, and general information questionnaires, the short version of the Intolerable Uncertainty Scale (IUS-12), the Family Caringness Rating Scale (APGAR), and World Health Organization Five Physical and mental health indicators (WHO-5) were used to investigate and analyze the influencing factors of intolerable uncertainty in elderly chronic disease co-morbid patients.

Results: The total IUS-12 score in elderly patients with chronic disease co-morbidities was (35.58 ± 3.24), the total APGAR score was (7.27 ± 2.29), and the total WHO-5 score was (17.37 ± 2.69). The total IUS-12 score of elderly chronic disease co-morbidities was negatively correlated with the total APGAR score (r=-0.884, P<0.01) and with the total WHO-5 score (r=-0.920, P<0.01). The results of multiple linear regression showed that rural area, living alone, family care and physical and mental health were independent influences on the intolerable uncertainty of elderly chronic co-morbid patients (P < 0.05).

Conclusions: The intolerable uncertainty of elderly patients with chronic disease co-morbidities is at a medium level, and clinical work should focus on the phenomenon of intolerable uncertainty of elderly patients with chronic disease co-morbidities, strengthen the early identification and nursing interventions for high-risk groups in rural areas, living alone, with low family care, and with poor physical and mental health, and give full play to the strengths of humanistic care in nursing to improve the quality of life. Urge policymakers to allocate targeted funding to underserved regions in order to expand access to specialized geriatric nursing services, telehealth infrastructure, and community-based support networks for patients living alone.