目的 探究脑卒中患者照顾者照顾能力在疾病不确定感与益处发现间的作用机制,为提高照顾者心理健康水平提供参考。方法 采用一般资料调查表、益处发现量表、中文版疾病不确定感家属量表、家属照顾者照顾能力量表于2022年1—5月对泸州市3所三级甲等医院的352对脑卒中患者和照顾者展开调查。结果 照顾者益处发现与疾病不确定感、照顾能力总分均呈负相关（r=-0.618,r=-0.608,均P<0.01）,疾病不确定感与照顾能力总分呈正相关（r=0.688,P<0.01）。构建的结构方程模型显示,疾病不确定感对益处发现的直接效应不显著（β=-0.539,P>0.05）,照顾能力在疾病不确定感与益处发现间起完全中介作用（β=-0.768,P<0.05）,中介效应占总效应（β=-1.307,P<0.05）的58.8%。结论 照顾能力是疾病不确定感与益处发现间的中介变量,提示医护人员应关注脑卒中患者照顾者的照顾能力水平并通过主动向其普及疾病、照护的相关知识予以提升,增强对照顾工作的掌控感降低不确定性,以便提高益处发现水平,最终减轻负性情绪维持心理健康。
Abstract
Objective To explore the mechanism of care ability between disease uncertainty and benefit finding in caregivers of stroke patients, and to provide reference for improving caregivers' mental health. Methods From January to May 2022, 352 stroke patients and their caregivers from three tertiary grade-A hospitals in Luzhou city were investigated by general data questionnaire, benefit finding scale, family caregiver task inventory and Chinese version of Mishel Uncertainty in Illness Scale for Family Member. Results The total score of benefit finding was negatively correlated with that of disease uncertainty and care ability (r=-0.618, r=-0.608, all P<0.01), and the total score of disease uncertainty was positively correlated with that of care ability (r=0.688, P<0.01). Structural equation model showed that the direct effect of disease uncertainty on benefit finding was not significant (β=-0.539, P>0.05); care ability played a completely mediating role between disease uncertainty and benefit finding (β=-0.768, P<0.05), accounting for 58.8% of the total effect (β=-1.307,P<0.05). Conclusion Care ability is a mediation variable between disease uncertainty and benefit finding. Medical staff should pay more attention to the care ability of caregivers of stroke patients and improve it by popularizing disease and care knowledge, enhancing their sense of control over care and reducing uncertainty, so as to promote benefit finding and reduce negative emotions.
关键词
脑卒中 /
照顾者 /
益处发现 /
疾病不确定感 /
照顾能力
Key words
stroke /
caregiver /
benefit finding /
disease uncertainty /
care ability
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基金
四川医院管理和发展研究中心青年基金项目（SCYG2020-28）; 泸州市社会心理服务与危机干预中心（LZXL-202212）
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