目的 分析慢性病资源利用在冠心病PCI术后患者自我超越与自我管理行为间的中介作用。方法 采用一般资料调查表、自我超越量表、慢性病资源调查问卷、冠心病自我管理行为量表对720例冠心病PCI术后患者进行问卷调查。结果 冠心病PCI术后患者自我超越、慢性病资源利用、自我管理行为总分分别为（43.70±5.91）分、（55.12±8.37）分和（72.57±8.17）分;自我超越与慢性病资源利用呈正相关（r=0.562,P<0.01）,两者与自我管理行为均呈正相关（r分别为0.516、0.717,P均<0.01）;慢性病资源利用在自我超越与自我管理行为间起部分中介作用,中介效应占总效应的68.02%。结论 冠心病PCI术后患者自我超越可以直接影响自我管理行为,也可以通过慢性病资源利用发挥作用。
Abstract
Objective To analyze the mediating role of chronic disease resource utilization between self-transcendence and self-management behaviors in postoperative coronary artery disease(CAD) patients after PCI. Methods A General Information Questionnaire, the Self-Transcendence Scale, the Chronic Disease Resource Questionnaire, and the Coronary Heart Disease Self-Management Behaviors Scale were used to survey 720 postoperative CAD patients after PCI. Results The total score of self-transcendence, chronic disease resource utilization, and self-management behaviors of patients after PCI was 43.70±5.91, 55.12±8.37, and 72.57±8.17, respectively. Self-transcendence was positively correlated with chronic disease resource utilization (r=0.562,P<0.01), and both were positively correlated with self-management behaviors (r=0.516, r=0.717, both P<0.01). Chronic disease resource utilization played a partial mediating role between self-transcendence and self-management behaviors, accounting for 68.02% of the total effect. Conclusion Self-transcendence in CAD patients after PCI can directly influence self-management behaviors and can also play a role through chronic disease resource utilization.
关键词
冠心病患者 /
冠状动脉介入治疗 /
自我超越 /
慢性病资源利用 /
自我管理行为 /
中介效应
Key words
coronary artery disease patient /
percutaneous coronary intervention /
self-transcendence /
chronic disease resource utilization /
self-management behaviors /
mediating effect
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Glasgow RE, Strycker LA, Toobert DJ, et al.A social-ecologic approach to assessing support for disease self-management: the Chronic Illness Resources Survey[J].J Behav Med, 2000,23(6):559-583.DOI: 10.1023/a:1005507603901.
[2] 钱艳,何英姿,朱玮,等.老年糖尿病患者健康信念、慢病资源利用与自我管理行为的关系研究[J].军事护理, 2022,39(12):58-61.DOI:10.3969/j.issn.2097-1826.2022.12.015.
[3] Reed PG, Haugan G.Self-transcendence: a salutogenic process for well-being[J]. 2021:103-115. DOI: 10.1007/978-3-030-63135-29.
[4] 吴妮娜,何建云,李娟.社区老年高血压患者自我超越与资源利用的相关性[J].护理学杂志, 2016,31(21):97-98.DOI: 10.3870/j.issn.1001-4152.2016.21.097.
[5] 倪平,陈京立,刘娜.护理研究中量性研究的样本量估计[J].中华护理杂志,2010, 45(4):378-380.DOI:10.3761/j.issn.0254-1769.2010.04.037.
[6] 陈莹莹. PCI术后冠心病患者自我管理能力影响因素的相关性分析[D].吉林:吉林大学, 2020.DOI:10.27162/d.cnki.gjlin.2020.000982.
[7] Reed PG.Toward a nursing theory of self-transcendence: deductive reformulation using developmental theories[J].ANS Adv Nurs Sci,1991,13(4):64-77.DOI:10.1097/00012272-199106000-00008.
[8] 张晶,孙建萍,张璐,等.中文版自我超越量表在老年人群中的信效度检验[J].中国老年学杂志,2014,34(7):1910-1911.
[9] Glasgow RE, Toobert DJ, Barrera MJ, et al.The Chronic Illness Resources Survey: cross-validation and sensitivity to intervention[J].Health Educ Res, 2005,20(4):402-409. DOI: 10.1093/her/cyg140.
[10] 钟慧琴,范玲,邵亚,等.中文版慢性病资源调查问卷应用于糖尿病患者的信效度分析[J]. 中国全科医学, 2014,17(23):2779-2782.DOI:10.3969/j.issn.1007-9572.2014.23.031.
[11] 王梦玉. 新疆住院冠心病患者自我管理行为及相关因素的研究[D].乌鲁木齐:新疆医科大学, 2011.DOI: 10.7666/d.d175716.
[12] 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.DOI:10.3724/SP.J.1042.2014.00731.
[13] 卢燕冰,何锦贤,陈国钦.介入治疗术后患者自我超越与社会支持和应对方式相关性研究[J].中华护理教育, 2021,18(4):369-372.DOI:10.3761/j.issn.1672-9234.2021.04.016.
[14] 康婵娟,关翠萍,古盈盈,等.脑出血恢复期患者自我超越水平现状及影响因素研究[J].中华护理教育, 2020,17(10):937-941.DOI:10.3761/j.issn.1672-9234.2020.10.015.
[15] 蔺可. 冠心病患者自我管理健康赋权现状及影响因素研究[D].成都:成都医学院, 2023. DOI:10.27843/d.cnki.gcdyy.2023.000203.
[16] Yao XY, Wang Y, Liu ZJ, et al.Influencing factors of resource utilisation in haemodialysis patients-based on socioecological pyramid model[J]. J Clin Nurs, 2022,31(5/6):770-780.DOI: 10.1111/jocn.15935.
[17] 韩景怡,刘芳丽,张红梅,等.冠心病PCI术后患者体力活动现状及影响因素分析[J]. 现代预防医学, 2020,47(14):2677-2680.
[18] Yang XL, Xie WY, Cai YM, et al.Investigation of the negative emotions exhibited in patients with Coronary Heart Disease after PCI and any influencing factors[J]. Psychol Res Behav Manag,2022,15:3027-3037.DOI:10.2147/PRBM.S379422.
[19] 肖雪,李婷,郑子月,等. 维持性血液透析患者自我超越与自我管理的相关性分析[J].世界最新医学信息文摘, 2019,19(26):53-55.DOI:10.19613/j.cnki.1671-3141.2019.26.023.
[20] Zhang X, Chen H, Liu Y, et al.Influence of chronic illness resources on self-management and the mediating effect of patient activation among patients with coronary heart disease[J]. Nurs Open, 2021,8(6):3181-3189. DOI: 10.1002/nop2.1031.
[21] Zhang F, Fu L, Wang L, et al.The effectiveness of self-management programme based on multilevel social resources utilization in diabetes mellitus patients: a randomized controlled study[J].Int J Nurs Pract,2023,29(3):e13138. DOI: 10.1111/ijn.13138.
[22] 王梅, 张利. 基于社会生态模型的老年高血压患者社会资源利用状况对自我管理行为的影响[J]. 职业与健康, 2020,36(7):917-922. DOI:10.13329/j.cnki.zyyjk.2020.0282.
基金
湖南师范大学医学院开放基金资助项目（KF2022039）; 湖南省科学技术厅重点领域研发计划（2020SK3041）
PDF(611 KB)
