类风湿关节炎患者生活质量影响因素的路径分析  

A path analysis of factors associated with quality of life among patients with rheumatoid arthritis

作　　者：龚桂兰[1] 张泽宇[1] 毛靖[1] 

机构地区：[1]华中科技大学同济医学院护理学院,湖北武汉430030

出　　处：《护理学杂志》2016年第21期24-27,共4页Journal of Nursing Science

基　　金：华中科技大学自主创新研究基金项目(2013QN002)

摘　　要：目的探讨疲劳、功能障碍、自我效能、社会支持对类风湿关节炎患者生活质量的影响及作用机制,为改善患者生活质量提供依据。方法采用多维疲劳量表、健康评定量表残疾指数、关节炎自我效能量表、社会支持量表、简明健康状况调查表对207例类风湿关节炎患者进行调查,根据Wilson-Cleary健康相关生活质量模式和相关性分析结果提出假设,使用AMOS软件进行结构方程模型分析。结果自我效能对生活质量有直接正向效应(路径系数为0.356),并通过疲劳、功能障碍对生活质量产生间接影响(路径系数为0.310);疲劳对生活质量有直接负向效应(路径系数为-0.321),又通过功能障碍间接影响生活质量(路径系数为-0.136);功能障碍对生活质量有直接负向效应(路径系数为-0.274);社会支持通过疲劳间接影响生活质量(路径系数为0.080)。结论提高类风湿关节炎患者的自我效能,改善疲劳,预防和减缓功能障碍,增加社会支持可提高其生活质量。Objective To explore the impact and mechanism of fatigue, functional disability, self-efficacy, and social support on quali- ty of life （QoL） among patients with rheumatoid arthritis （RA）. Methods A total of 207 patients with RA were investigated using the Multidimensional Fatigue Inventory, Health Assessment Questionnaire Disability Index, Arthritis Self-Efficacy Scale-8 Item, MOS Social Support Survey, and MOS 36-item Short Form Health Survey. Hypotheses were proposed based on the Wilson-Cleary model of health-related quality of life and the results of correlation analysis, and then structural equation modeling procedures were performed using AMOS software. Results Self-efficacy had a direct positive effect on QoL, with path coefficient being 0. 356; and had an indirect effect on QoL through both fatigue and functional disability （path coefficient= 0. 310）. Fatigue directly and indi- rectly affected QoL via functional disability, with the path coefficients being --0. 321 and --0. 136, respectively. Functional disabi- lity had a direct negative effect on QoL （path coefficient=- 0. 274） and social support had an indirect effect on QoL via fatigue （path coefficient= 0. 080）. Conclusion Nurses should take actions to strengthen RA patientsr self-efficacy, relieve fatigue, prevent or delay the onset 0f physical disability, and increase social support, thus to improve their QoL.

关 键 词：类风湿关节炎 生活质量 疲劳 功能障碍 自我效能 社会支持 影响因素 路径分析 

分 类 号：R473.5[医药卫生—护理学]