自尊、心理控制源在慢性心力衰竭老年患者再入院次数和自我感受负担间的多重中介作用  

Multiple mediating effects of self-esteem and source of psychological control on readmission and self-perceived burden in elderly with chronic heart failure

作　　者：柳秋实[1] 魏子秀[2] 李伟[3] 刘晓培 张秀平[4] 刘鹏飞[1] Liu Qiushi;Wei Zixiu;Li Wei;Liu Xiaopei;Zhang Xiuping;Liu Pengfei(Gerontological Assessment and Management Center,School of Nursing,Jining Medical University,Jining 272013,China;Department of Cardiology,the First People's Hospital of Jining,Jining 272013,China;Nursing Department,Affiliated Hospital of Jining Medical University,Jining 272013,China;College of Adult Education,Jining Medical University,Jining 272013,China)

机构地区：[1]济宁医学院护理学院老年综合评估和管理中心,272013 [2]济宁市第一人民医院心内科,272013 [3]济宁医学院附属医院护理部,272013 [4]济宁医学院成人教育学院,272013

出　　处：《中华行为医学与脑科学杂志》2020年第5期458-463,共6页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：山东省人文社会科学课题(19-ZC-FX-03);山东省高等学校人文社会科学课题(J15WG36)。

摘　　要：目的:探讨自尊和心理控制源在慢性心力衰竭老年患者再入院次数和自我感受负担间的中介作用。方法:选取5所三级医院346例慢性心力衰竭老年患者,患者病情稳定时采用自我感受负担量表(self-perceived burden scale,SPBS)、自尊量表(the self esteem scale,SES)和多维度健康心理控制源量表(multidimentional health locus of control scale,MHLC)进行调查。SPSS 20.0进行双变量相关分析和多元线性逐步回归构建结构方程模型;Process 2.13.2插件进行Bootstrap中介效应检验;AMOS 23.0进行结构方程模型验证和路径分析。结果:(1)慢性心力衰竭老年患者最近一年再入院次数为0~8次, M( P25, P75)为1(1,3)次;自尊量表平均分为(29.25±3.67)分,心理控制源中内控性得分为(22.67±3.85)分;有势力他人得分为(26.45±3.38)分;机遇得分为(19.84±3.82)分;SPBS平均得分为(22.19±9.49)分。(2)SPBS总分与自尊显著负相关( r=-0.359, P<0.01),机遇心理控制源显著正相关( r=0.169, P<0.01);自尊与内控性( r=0.237, P<0.01)、有势力他人心理控制源( r=0.225, P<0.01)显著正相关。因心力衰竭再入院次数与自尊( r=-0.119, P<0.05)显著负相关,与内控性心理控制源显著负相关( r=-0.173, P<0.01)、与自我感受负担显著正相关( r=0.219, P<0.01)。(3)结构方程模型和中介效应分析结果显示:再入院次数、自尊、心理控制源可以解释自我感受负担总变异的18.0%;自尊和心理控制源在再入院次数和自我感受负担间存在中介作用,中介效应占总效应的20.00%。 结论:自尊和心理控制源在再入院次数和自我感受负担间存在部分中介作用,提高慢性心力衰竭老年患者的自尊水平,促进积极的内控性应对策略,将可能更加有效的缓解自我感受负担。Objective To analyze the mediating role of self-esteem and control sources in readmission frequency and self-perceived burden of elderly patients with chronic heart failure(CHF).Methods A total of 346 cases of elderly patients with CHF were included,using self-perceived burden scale(SPBS),self-esteem scale(SES)and multidimensional health locus of control scale(MHLC)to investigate.SPSS 20.0 software was employed to coduct Pearson and Spearman correlation analysis and multiple linear stepwise regression to construct the structural equation model.Process 2.13.2 plug-in was used to test the intermediate effect of Bootstrap.AMOS 23.0 was used for structural equation model and path analysis verification.Results(1)The readmission frequency during the recent years of the elderly patients with CHF was 0-8,and M(P25,P75)was 1(1,3).The mean score of self-esteem scale was(29.25±3.67),and the score of internal control in psychological control source was(22.67±3.85).The score of influential others was(26.45±3.38).The opportunity score was(19.84±3.82).The mean SPBS score was(22.19±9.49).(2)SPBS total score was significantly negatively correlated with self-esteem(r=-0.359,P<0.01),positively correlated with opportunity control source(r=0.169,P<0.01).Self-esteem was positively correlated with internal control(r=0.237,P<0.01),control of influential others(r=0.225,P<0.01).The readmission frequencies of CHF were significantly negatively correlated with self-esteem(r=-0.119,P<0.05)and internal control(r=-0.173,P<0.01),positively correlated with SPBS(r=0.219,P<0.01).(3)Multiple regression and structural equation model results showed that readmission,self-esteem and psychological control sources could account for 18.0%of the total variables of self-perceived burden.The relationship between readmission and self-perceived burden was mediated by self-esteem and locus of control,accounting for 20.00%of the total effect.Conclusion Self-esteem and control sources are partially mediating the effect between readmission and self-perceived b

关 键 词：慢性心力衰竭 自尊 心理控制源 自我感受负担 多重中介效应 

分 类 号：R541[医药卫生—心血管疾病]