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护理学报 ›› 2024, Vol. 31 ›› Issue (18): 50-55.doi: 10.16460/j.issn1008-9969.2024.18.050

• 调查研究 • 上一篇    下一篇

377例社区老年多重慢病患者心理困扰现状及影响因素分析

杨侠1,2, 于卫华1,2, 张雨溪1, 邓曼1, 任影1, 张利1, 张海燕1   

  1. 1.安徽医科大学 护理学院,安徽 合肥 230601;
    2.安徽医科大学第三附属医院 合肥市第一人民医院,安徽 合肥 230061
  • 收稿日期:2024-01-02 出版日期:2024-09-25 发布日期:2024-10-08
  • 通讯作者: 于卫华（1963-）,女,安徽阜阳人,本科学历,主任护师,硕士研究生导师。E-mail：ywh-zr@tom.com
  • 作者简介:杨侠（1996-）,女,安徽淮北人,本科学历,硕士研究生在读,护士。
  • 基金资助:
    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）

Status quo and influencing factors of psychological distress in community elderly patients with multiple chronic diseases：a 377-case study

YANG Xia1,2, YU Wei-hua1,2, ZHANG Yu-xi1, DENG Man1, REN Ying1, ZHANG Li1, ZHANG Hai-Yan1   

  1. 1. School of Nursing, Anhui Medical University, Hefei 230601, China;
    2. The Third Affiliated Hospital of Anhui Medical University, the First People’s Hospital of Hefei, Hefei 230061, China
  • Received:2024-01-02 Online:2024-09-25 Published:2024-10-08

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摘要： 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。

关键词: 老年人, 多重慢病, 心理困扰, 心理弹性, 老化态度

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.

Key words: elderly individual, multiple chronic diseases, psychological distress, resilience, attitudes toward aging

中图分类号: 

  • R473.2
[1] 齐元涛,柳言,杜金,等.基于健康生态学模型的我国老年人慢性病共病影响因素研究[J].中国全科医学, 2023,26(1):50-57.
[2] Yang L, Zhao M, Magnussen CG, et al.Psychological distress and mortality among US adults: prospective cohort study of 330-367 individuals[J]. J Epidemiol Community Health,2020,74(4):384-390.DOI:10.1136/jech-2019-213144.
[3] Ridner SH.Psychological distress: concept analysis[J].J Adv Nurs, 2004, 45(5):536-545.DOI:10.1046/j.1365-2648.2003.02938.x.
[4] 姚树桥,杨艳杰,潘芳,等.医学心理学[M]. 7版.北京:人民卫生出版社,2018.
[5] 范肖冬. ICD-10精神与行为障碍分类临床描述与诊断要点[M].北京:人民卫生出版社,1993.
[6] 马斌荣. 医学统计学[M].4版.北京:人民卫生出版社,2004.
[7] Kessler RC, Andrews G, Colpe LJ, et al.Short screening scales to monitor population prevalences and trends in non-specific psychological distress[J]. Psychol Med,2002,32(6):959-976.DOI:10.1017/s0033291702006074.
[8] 周成超,楚洁,王婷,等.简易心理状况评定量表Kessler10中文版的信度和效度评价[J].中国临床心理学杂志,2008,16(6):627-629.DOI:10.16128/j.cnki.1005-3611.2008.06.026.
[9] 周成超,何江江,徐凌忠,等.Kessler10量表在我国老年人心理健康测评中的初次应用[J].中国临床心理学杂志,2009,17(6):761-763.DOI:10.16128/j.cnki.1005-3611.2009.06.003.
[10] Laidlaw K, Power MJ, Schmidt S, et al.The Attitudes to Ageing Questionnaire (AAQ):development and psychometric properties[J].Int J Geriatr Psychiatry,2007,22(4):367-379. DOI:10.1002/gps.1683.
[11] 黄一帆,王大华,刘永广,等.老化态度问卷(AAQ)中文版的初步试用[J].中国临床心理学杂志,2010,18(4):447-450.DOI:10.16128/j.cnki.1005-3611.2010.04.021.
[12] 安适,袁娟,陈涛,等.自评健康在老年人自理能力和抑郁症状之间的中介效应[J].护理学报,2022,29(20):55-59.DOI:10.16460/j.issn1008-9969.2022.20.055.
[13] 肖水源. 《社会支持评定量表》的理论基础与研究应用[J].临床精神医学杂志,1994(2):98-100.
[14] Connor KM, Davidson JRT.Development of a new resilience scale: the Connor-Davidson Resilience Scale(CD-RISC)[J].Depress Anxiety,2003,18(2):76-82.DOI:10.1002/da.10113.
[15] Campbell-Sills L, Stein MB.Psychometric analysis and refinement of the Connor-davidson Resilience Scale(CD-RISC): validation of a 10-item measure of resilience[J]. J Trauma Stress,2007,20(6):1019-1028.DOI:10.1002/jts.20271.
[16] Wang L, Shi Z, Zhang Y, et al.Psychometric properties of the 10-item Connor-Davidson Resilience Scale in Chinese earthquake victims[J].Psychiatry Clin Neurosci,2010,64(5):499-504.DOI:10.1111/j.1440-1819.2010.02130.x.
[17] Feifel H, Strack S, Nagy VT.Coping strategies and associated features of medically ill patients[J].Psychosom Med,1987, 49(6):616-625.DOI:10.1097/00006842-198711000-00007.
[18] 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(1):22-24.
[19] 汤丹丹,温忠麟.共同方法偏差检验:问题与建议[J].心理科学,2020,43(1):215-223.DOI:10.16719/j.cnki.1671-6981.20200130.
[20] 吴化宇,丁婕,雒朝君,等.基于验证性因子分析的中医工作满意度量表研制[J].中国卫生统计,2019,36(1):92-95.
[21] 邱皓政. 结构方程模型的原理与应用[M].2 版.北京:中国轻工业出版社,2019:25.
[22] Yang S, Li J, Zhao D, et al.Chronic conditions,persistent pain, and psychological distress among the rural older adults: a path analysis in Shandong, China[J].Front Med,2021,8:770914.DOI:10.3389/fmed.2021.770914.
[23] Badu E, O’Brien AP, Mitchell R, et al. Workplace stress and resilience in the Australian nursing workforce: a comprehensive integrative review[J]. Int J Ment Health Nurs,2020,29(1):5-34.DOI:10.1111/inm.12662.
[24] Poudel-Tandukar K, Chandler GE, Jacelon CS, et al.Resilience and anxiety or depression among resettled Bhutanese adults in the United States[J].Int J Soc Psychiatry,2019,65(6):496-506.DOI:10.1177/0020764019862312.
[25] 梁韵仪,殷文君,申乔乔,等.老化态度在老年人家庭功能与生命意义感的中介效应分析[J].护理学报,2021,28(8):39-43.DOI:10.16460/j.issn1008-9969.2021.08.039.
[26] 秦立伟,罗艳艳,常红娟,等.社区老年人孤独感、抑郁与自我感知老化的关系研究[J].中国社会医学杂志,2022,39(4):445-449.DOl:10.3969/j.issn 1673-5625.2022.04.020.
[27] Choi EY, Um S, Shin H, et al.Attitudes toward aging, active coping, and depressive symptoms among middle-aged and older Korean adults: how do they differ by age group?[J].J Affect Disord,2022,296:380-387.DOI:10.1016/j.jad.2021.09.086.
[28] Jing Y, Wang W, Peng W, et al.Social support and cognitive function in Chinese older adults who experienced depressive symptoms: is there an age difference?[J].Front Aging Neurosci,2023,15:1175252.DOI:10.3389/fnagi.2023.1175252.
[29] Fahmy C, Testa A.Stress among older adults with an incarcerated family member: testing the buffering model of social support[J]. J Gerontol B Psychol Sci Soc Sci,2021,76(10):2057-2062.DOI:10.1093/geronb/gbab117.
[30] 冀云,李进伟.中国老年人社会支持与老化态度的关系研究[J].中国全科医学,2017,20(7):852-858.DOI:10.3969/j.issn.1007-9572.2017.07.018.
[31] 张勰,腾佳杉.我国老年人焦虑状况及其影响因素分析[J].现代预防医学, 2022, 49(16):2974-2979.DOI:10.20043/j.cnki.MPM.202204306.
[32] 任俊威,王志中.应对方式在老年心血管病患者依恋和健康赋权间的中介效应[J].中国全科医学,2020,23(S1):95-98.
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