住院胃肠癌症病人照顾者抑郁与成人依恋、社会支持的关系  

Relationship among adult attachment,social support and depression in caregivers of inpatients with gastrointestinal cancer

作　　者：陈晓云 金莉[1] 娄凤兰[2] Chen Xiaoyun;Jin Li(Lou Fenglan Shandong Women＇s University,Shandong 250300 China)

机构地区：[1]山东女子学院 [2]山东大学护理学院

出　　处：《循证护理》2018年第9期769-775,共7页Chinese Evidence-Based Nursing

摘　　要：[目的]了解住院胃肠癌症病人照顾者抑郁的发生情况,探讨成人依恋、社会支持对抑郁的影响并验证成人依恋、社会支持和抑郁三者之间的相互关系。[方法]方便选取207名某三级甲等医院住院胃肠癌症病人照顾者为研究对象,采用医院焦虑抑郁量表中的抑郁分量表、亲密关系体验问卷—修订版、社会支持评定量表分别评估照顾者的抑郁水平、成人依恋状况以及照顾者的社会支持情况。使用单因素分析以及结构方程模型验证照顾者成人依恋、社会支持与抑郁的相互关系。[结果]住院胃肠癌症病人照顾者抑郁得分为9.80分±4.19分,66.2%的照顾者报告有明显抑郁。单因素分析显示照顾者与病人的关系、是否已病人为依恋对象以及对病人病情严重程度感知影响照顾者抑郁水平。结构方程模型验证了社会支持可以直接影响照顾者的抑郁水平,社会支持可以完全中介依恋回避和依恋焦虑对照顾者抑郁的作用,其中介效应量分别为0.240和0.275。[结论]照顾住院胃肠癌症病人影响了照顾者的心理健康,成人依恋在社会支持对照顾者抑郁的影响中有中介作用。提示医务工作者可以对不同成人依恋类型的照顾者进行针对性的健康教育,指导其合理利用社会支持,减轻照顾者抑郁水平。Objective：To explore the prevalence of depression in caregivers of inpatients with gastrointestinal cancer,to further probeinto the influence of caregivers＇ adult attachment and social support on their depression,and to identify the relationship among depression,adult attachment and social support in caregivers.Methods：Participants were 207 caregivers of inpatients with gastrointestinal cancer from a third guade-A comprehensive hospital a total of 237 question.The experiences in Close Relationships Questionnaire-Revised,Social Support Rating Scale and the HD from Hospital Anxiety and Depression Scale were used to measure their adult attachment,social support and psychological distress.Univariate analysis and the structural equation model were used to explore the influence of related factors on depression.Results：The mean scores of psychological distress was9.80±4.19,66.2%caregivers showed depression.The relationship between caregiver and patient,the severity of illness caregivers＇ perception,social support and attachment figure were predicted caregivers＇ depression.The mediating effort of social support between adult attachment and depression was significantly（mediator effort=0.240,0.275）.Conclusions：Carving inpatients with gastrointestinal cancer have bad effect on caregivers＇ mental health,social support complete mediating the role of adult attachment on depression.The mechanism of adult attachment to the caregiver depression was found.Targeted health education to caregivers with different adult attachment styles should be given by medical workers to guide caregivers to make rational use of social support and alleviate their depression.

关 键 词：胃肠癌症病人 住院照顾者 抑郁 成人依恋 社会支持 

分 类 号：R473.73[医药卫生—护理学]