应对方式在永久性肠造口患者心理韧性与社会心理适应的中介效应
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摘要
目的探讨应对方式在永久性肠造口患者心理韧性与社会心理适应之间的中介作用。方法对242例永久性肠造口患者采用一般资料调查表、心理韧性量表、医学应对问卷和造口患者社会心理适应量表进行调查。使用AMOS 24.0及非参数百分位Bootstrap法对应对方式的中介效应进行检验分析。结果永久性肠造口患者社会心理适应平均得分为(45.07±11.67)分,心理韧性与社会心理适应之间呈正相关(P<0.01),面对与心理韧性、社会心理适应亦呈正相关(P<0.01);屈服与心理韧性、社会心理适应呈负相关(P<0.01)。应对方式在心理韧性与社会心理适应之间起到部分中介的作用,中介效应占总效应的比例为56.7%。结论应对方式在肠造口患者心理韧性平与社会心理适应之间起部分中介作用,可以通过提高患者的心理韧性水平来促进患者对造口的适应行为。
Objective To explore the mediating role of coping styles on the relationship between resilience and psychosocial adaptation in permanent colostomy patients. Methods A total of 242 patients with permanent colostomy were investigated with general information questionnaire, Connor-Davidson Resilience Scale(CD-RISC), Medical Coping Modes Questionnaire(MCMQ) and Ostomy Adjustment Inventory-23(OAI-23). The mediating effect of coping style was tested by using AMOS24.0 and nonparametric percentile Bootstrap method. Results The mean score of psychosocial adaptation was(45.07±11.67)in permanent colostomy patients, and there was a positive correlation between resilience and the total score of psychosocial adaptation(P<0.01). The relationships between facing and resilience, psychosocial adaptation was positively correlated(P<0.01). The yield coping negatively correlated with resilience and psychosocial adaptation(P <0.01). Coping modes play a partial intermediary role between resilience and psychosocial adaptation. The ratio of mediating effect to total effect is 56.7%.Conclusion Coping modes plays a partial mediating role between resilience and psychosocial adaptation among the patients with permanent colostomy. The patients' adaptation to stoma can be promoted by improving the patients' psychological resilience level.
Objective To explore the mediating role of coping styles on the relationship between resilience and psychosocial adaptation in permanent colostomy patients. Methods A total of 242 patients with permanent colostomy were investigated with general information questionnaire, Connor-Davidson Resilience Scale(CD-RISC), Medical Coping Modes Questionnaire(MCMQ) and Ostomy Adjustment Inventory-23(OAI-23). The mediating effect of coping style was tested by using AMOS24.0 and nonparametric percentile Bootstrap method. Results The mean score of psychosocial adaptation was(45.07±11.67)in permanent colostomy patients, and there was a positive correlation between resilience and the total score of psychosocial adaptation(P<0.01). The relationships between facing and resilience, psychosocial adaptation was positively correlated(P<0.01). The yield coping negatively correlated with resilience and psychosocial adaptation(P <0.01). Coping modes play a partial intermediary role between resilience and psychosocial adaptation. The ratio of mediating effect to total effect is 56.7%.Conclusion Coping modes plays a partial mediating role between resilience and psychosocial adaptation among the patients with permanent colostomy. The patients' adaptation to stoma can be promoted by improving the patients' psychological resilience level.
引文
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[14] Popa-Velea O, Diaconescu L, Jidveian PM, et al. Resilience and active coping style:Effects on the self-reported quality of life in cancer patients[J]. The International Journal of Psychiatry in Medicine, 2017, 52(2):124-136.
[15] Lou VW, Ng JW. Chinese older adults'resilience to the loneliness of living alone:A qualitative study[J]. Aging&Mental Health, 2012, 16(8):1039-1046.
[16]唐青峰,张国琴.恶性肿瘤患者主要照顾者心理弹性在社会支持与应对方式间的中介效应[J].现代预防医学,2017,44(24):4478-4481.
[17]李思思,梁春光,王玥,等.冠心病患者应对方式在正念水平和健康行为之间的中介效应[J].现代预防医学,2017,44(14):2593-2596.
[2] Dong XL, Li GP, Liu CL, et al. The mediating role of resilience in the relationship between social support and posttraumatic growth among colorectal cancer survivors with permanent intestinal ostomies:A structural equation model analysis[J]. European Journal of Oncology Nursing, 2017, 29:47-52.
[3]羊丽芳,程芳,魏青.直肠癌Miles术后行结肠造口灌洗患者社会心理适应水平的调查及分析[J].中华现代护理杂志,2017,23(27):3534-3536.
[4]徐芳芳.直肠癌永久性肠造口患者病耻感与应对方式、造口适应、生活质量的相关性研究[D].合肥:安徽医科大学,2016.
[5] Connor KM, Davidson JR. Development of a new resilience scale:the Connor-Davidson Resilience Scale(CD-RISC)[J]. Depression and Anxiety, 2003, 18(2):76-82.
[6] Temprado MD, Agut S, Collado E. The mediating role of resilience in the relationship between personality and adjustment to disease in patients with a drainage enterostomy[J]. Journal of Health Psychology, 2017:1-15.
[7]刘砚燕,袁长蓉.肠造口患者术后适应水平影响因素的研究进展[J].中华护理杂志,2012,47(4):379-382.
[8] Yu XN, Zhang JX. Factor analysis and psychometric evaluation of the Connor-Davidson Resilience Scale(CD-RISC)with Chinese People[J]. Social Behavior and Personality, 2007, 35(1):19-30.
[9]沈晓红,姜乾金.医学应对方式问卷中文版701例测试报告[J].中国行为医学科学,2000,9(1):18-20.
[10]皋文君,袁长蓉.中文版造口患者适应量表的信效度测评[J].中华护理杂志,2011,46(8):811-813.
[11]温忠麟,叶宝娟.中介效应分析:方法和模型发展[J].心理科学进展,2014,22(5):731-745.
[12]朱文娟,吴爱玲,杨群英.同伴支持小组协同护理模式对肠造口患者自我护理和适应水平的影响[J].护理学杂志,2015,30(4):5
[13]谢玲平,王洪礼,邹维兴,等.留守初中生自我效能感与社会适应的关系:心理韧性的中介作用[J].中国特殊教育,2014(7):52-58.
[14] Popa-Velea O, Diaconescu L, Jidveian PM, et al. Resilience and active coping style:Effects on the self-reported quality of life in cancer patients[J]. The International Journal of Psychiatry in Medicine, 2017, 52(2):124-136.
[15] Lou VW, Ng JW. Chinese older adults'resilience to the loneliness of living alone:A qualitative study[J]. Aging&Mental Health, 2012, 16(8):1039-1046.
[16]唐青峰,张国琴.恶性肿瘤患者主要照顾者心理弹性在社会支持与应对方式间的中介效应[J].现代预防医学,2017,44(24):4478-4481.
[17]李思思,梁春光,王玥,等.冠心病患者应对方式在正念水平和健康行为之间的中介效应[J].现代预防医学,2017,44(14):2593-2596.