心理弹性在全膝关节置换术后患者社会支持和生活质量之间的中介作用  

Mediation effect of psychological resilience between social support and quality of life in the postoperative patients with total knee replacement surgery

作　　者：马春洋 孙丽敏[1] 廉爱玲[1] 

机构地区：[1]哈尔滨医科大学附属第一医院门诊中心手术室,哈尔滨150001

出　　处：《中华现代护理杂志》2017年第28期3576-3581,共6页Chinese Journal of Modern Nursing

摘　　要：目的 了解老年全膝关节置换术后3个月患者生活质量情况,分析心理弹性在术后患者社会支持和生活质量之间的中介作用.方法 选取哈尔滨某三级甲等医院2014年10月—2016年10月收治的首次接受双侧人工全膝关节置换术的208例患者为研究对象,采用一般情况问卷、社会支持量表（SSRS）、心理弹性量表（CD-RISC）、健康状况调查问卷（SF-36）,对术后患者进行问卷调查.结果 本组患者术后3个月的心理弹性总分（51.29±11.70）分,社会支持总分（35.78±7.12）分,生活质量总分（69.13±4.96）分,均低于国内常模,差异有统计学意义（t值分别为-14.876、-17.418、-26.317;P〈0.05）.心理弹性在社会支持和躯体健康生活质量之间发挥着部分中介作用,中介作用大小为0.053,占总效应的11.30％;心理弹性在社会支持对精神生活质量的影响中发挥部分中介作用,中介作用大小为0.066,占总效应的27.73％.结论 术后患者生活质量较差,社会支持既可正向预测患者的生活质量,又能通过心理弹性间接影响生活质量.心理弹性决定了社会支持对术后患者生活质量的正面效应.应为患者建立良好的社会支持体系,提高心理弹性水平,进而提高患者术后生活质量.Objective To understand the quality of life of the elderly patients with the total knee replacement three months after the surgery and to analyze the mediation effect of psychological resilience on the relationship between the social support and the quality of life among the postoperative patients.Methods Two hundred and eight patients who first received the bilateral artificial total knee replacement in some Harbin class Ⅲ grade A hospital from October 2014 to October 2016 were included. They were investigated by the general situation questionnaire, the social support scale （SSRS）, the psychological resilience scale （CD-RISC） and the health status questionnaire （SF-36）.Results Three months after surgery, the total score of the psychological resilience, the social support, the quality of life of the included patients was（51.29±11.70）,（35.78±7.12） and（69.13±4.96）, which were all significantly lower compared to the domestic norm （t=-14.876,-17.418, -26.317;P〈0.05）. The psychological resilience played a partial intermediary role between the social support and the quality of life of physical health. The mediation effect was 0.053, accounting for 11.30％ of the total effect. The psychological resilience played a partial intermediary role between the social support and the quality of life of mental health. The mediation effect was 0.066, accounting for 27.73％ of the total effect. Conclusions The quality of life was reduced in the postoperative patients with the total knee replacement surgery. The social support can predict the quality of life of the patients positively and it has an indirect influence which is mediated by the psychological resilience on the patients＇ quality of life. The psychological resilience mediates the positive effect of the social support on the postoperative patients＇ quality of life. A good social support system should be established for patients and the psychological resilience level should be enhanced, in order to improve the postoperative patients�

关 键 词：全膝关节置换术 生活质量 心理弹性 社会支持 

分 类 号：R473.6[医药卫生—护理学]