精神分裂症患者家属应对方式在病耻感及社会支持中的中介效应  

The mediating effect of coping style of family members of schizophrenics on stigma and social support

作　　者：艾宪英 郑美[1] 王爱青[1] 刘桂花[1] 徐清芝[1] 掌永莉[1] Ai Xianying;Zheng Mei;Wang Aiqing;Liu Guihua;Xu Qingzhi;Zhang Yongli(Shandong Mental Health Center,Jinan Shandong 250014)

机构地区：[1]山东省精神卫生中心,山东济南250014

出　　处：《护士进修杂志》2020年第24期2209-2214,共6页Journal of Nurses Training

基　　金：山东省精神卫生中心科技发展计划项目(编号:2019YJ04)。

摘　　要：目的探讨应对方式在精神分裂症患者家属病耻感与领悟社会支持间的中介作用,为临床制定有效干预措施,减轻其病耻感提供依据。方法采用方便抽样法对2019年4-11月在山东省精神卫生中心住院的155例精神分裂症患者及其家属(均选取1位与患者有血缘关系的家属),应用一般资料调查表、病耻感系列量表中的贬低-歧视感知量表、简易应对方式问卷和领悟社会支持量表进行调查,并使用AMOS 22.0建立结构方程模型进行验证分析。结果患者家属病耻感均分为(2.59±0.50)分;积极应对均分为(1.86±0.52)分,消极应对均分为(1.24±0.45)分;领悟社会支持总分为(59.77±13.39)分,其中家庭支持(20.50±4.82)分、朋友支持(19.32±4.73)分、其它支持(19.94±4.87)分。精神分裂症患者家属病耻感与积极应对、家庭支持、朋友支持及其它支持呈负相关(r=-0.650^-0.356,P<0.01),与消极应对呈正相关(r=0.232、0.183、0.159、0.215,P<0.01),积极应对与家庭支持、朋友支持、其它支持呈正相关(r=0.363~0.314,P<0.01),家庭支持与朋友支持和其它支持成正相关(r=0.741、0.784,P<0.01)。结构方程模型显示:领悟社会支持→消极应对→病耻感”的中介效应不显著(β=0.025,P=0.268),予以剔除。“领悟社会支持→积极应对→病耻感”间接效应显著,领悟社会支持可直接负向预测病耻感,路径系数为-0.25,领悟社会支持也可通过积极应对间接影响病耻感,效应值为-0.331,中介效应比例占总效应的56.64%。结论积极应对在精神分裂症患者家属病耻感与领悟社会支持间起中介作用,关注精神分裂症患者家属的领悟社会支持和应对方式,有助于降低其病耻感水平。Objective To study the mediating effect of coping style on stigma and social support of family members of schizophrenics,so as to provide evidence for clinical intervention and alleviation the level of stigma perceived.Methods:From April 2019 to November 2019,155 relatives of schizophrenics were selected as the study objects,Link's perceived devalnation discrimination scale and simple coping style questionnaire and perceived social support scale were used for investigation.AMOS 22.0 is used to establish the structural equation model for verification and analysis.Results:Total score of perceived devaluation discrimination for 155 relatives of schizophrenics was(2.59±0.50)points.The average score of positive coping was(1.86±0.52)points.The average score of negative coping was(1.24±0.45)points.The total score of perceived social support was(59.77±13.39)points.The average score of family support was(20.50±4.82)points,friend support was(19.32±4.73)points,and other support was(19.94±4.87)points.Positive coping style,family support,friend support and other support of family members of schizophrenics were negatively correlated with stigma(r=-0.650^-0.356,P<0.01).Scores of stigma were positively correlated with scores of negative coping(r=0.232、0.183,0.159,0.215,P<0.01).Positive coping is positively correlated with family support,friend support and other support(r=0.363~0.314,P<0.01).Family support was positively correlated with friend support and other support(r=0.741,0.784,P<0.01).Structural equation model showed that the mediating effect of"perceived social support→negative coping→perceived devaluation-discrimination"was not significant(β=0.025,P=0.268),and was eliminated.The indirect effect of"perceived social support→positive coping→perceived devaluation discrimination"is significant.Understanding social support can directly and negatively predict level of stigma perceived.The path coefficient is-0.25.Understanding social support can also affect level of stigma perceived indirectly through positive

关 键 词：精神分裂症 家属 积极应对 消极应对 领悟社会支持 病耻感 中介效应 护理 

分 类 号：R473.74[医药卫生—护理学] R749.3[医药卫生—临床医学]