目的 了解社区老年多重慢病患者现状,并构建基于应激过程理论的结构方程模型,分析影响其心理困扰的路径。方法 采用便利抽样法,选取2023年8—11月合肥市3所社区服务中心就诊的377例老年多重慢病患者。采用一般资料调查表、凯斯勒心理困扰量表、心理弹性量表、社会支持评定量表、自评健康调查问卷、老化态度问卷、医学应对方式问卷进行调查。结果 老年多重慢病患者心理困扰总分为（21.18±5.76）分。心理弹性、老化态度、社会支持对其心理困扰具有负向预测效应,总效应值分别是-0.566、-0.441、-0.347。自评健康、屈服应对方式对心理困扰具有正向预测效应,总效应值分别是0.292、0.216。结论 老年多重慢病患者心理困扰水平较高,社区医务工作者应重视心理弹性、老化态度、社会支持、自评健康、屈服应对方式的影响,并采取针对性护理措施降低老年患者的心理困扰水平。
Abstract
Objective To understand the current situation of elderly patients with multiple chronic diseases in the community and to construct a structural equation model based on the theory of stress process to analyze the pathways influencing their psychological distress. Methods Convenient sampling was used to select 377 elderly patients with multiple chronic diseases who visited three community service centers in Hefei from August to November 2023. Surveys were conducted using a General Information Questionnaire, the 10-item Kessler Psychological Distress Scale, 10-item Connor-Davidson Resilience Scale, Social Support Rating Scale, Self-rated Health Questionnaire, Attitudes toward Aging Questionnaire, and Medical Coping Modes Questionnaire. Results The total score of psychological distress in elderly patients with multiple chronic diseases was 21.18±5.76. Psychological resilience, attitudes toward aging, and social support had negative predictive effects on psychological distress, with total effect value of -0.566, -0.441, and -0.347, respectively. Self-rated health and submissive coping styles had positive predictive effect on psychological distress, with total effect value of 0.292 and 0.216, respectively. Conclusion Serious psychological distress in elderly patients with multiple chronic diseases is observed. Community healthcare workers should pay attention to the influence of psychological resilience, attitudes toward aging, social support, self-rated health, and submissive coping styles, and take targeted nursing measures to alleviate psychological distress in elderly patients.
关键词
老年人 /
多重慢病 /
心理困扰 /
心理弹性 /
老化态度
Key words
elderly individual /
multiple chronic diseases /
psychological distress /
resilience /
attitudes toward aging
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基金
科技部重点研发计划项目（2020YFC2008802）; 安徽医科大学护理学院研究生青苗培育项目（hlqm12024067）
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