神经重症患者家属创伤后成长的影响因素及路径分析  

Analysis of influencing factors and pathway of post-traumatic growth in family members of neurosurgical intensive care unit patients

作　　者：林琪 董芳辉[1] 曾莉[2] 俞群亚[3] 薛翌蔚[4] LIN Qi;DONG Fanghui;ZENG Li;YU Qunya;XUE Yiwei

机构地区：[1]上海交通大学附属第六人民医院护理部,上海市201306 [2]同济大学附属第十人民医院神经重症监护病房 [3]上海交通大学附属第六人民医院普外科,上海市201306 [4]上海交通大学附属第六人民医院重症监护病房,上海市201306

出　　处：《中华护理杂志》2021年第6期836-842,共7页Chinese Journal of Nursing

基　　金：国家自然科学基金(72004162)。

摘　　要：目的了解神经重症患者家属创伤后成长现状,分析希望、感恩、心理弹性对创伤后成长的影响。方法 2019年1月—12月,采用便利抽样法,选取上海市某三级甲等医院神经外科ICU 340名患者家属作为研究对象。应用Herth希望量表、感恩问卷、心理弹性量表及创伤后成长评定量表对其进行调查。结果340名神经重症患者家属创伤后成长总分为(73.38±14.02)分。患者家属创伤后成长与希望、感恩、心理弹性水平分别呈显著正相关(r=0.319、0.396、0.654,均P<0.01)。Bootstrap分析显示,感恩、心理弹性在希望和创伤后成长关系里的中介效应显著(95%CI为0.743~1.226)。希望可以分别通过感恩和心理弹性正向预测创伤后成长(β=0.145,P<0.01;β=0.734,P<0.01),也可以通过感恩经心理弹性的多重中介正向预测创伤后成长(β=0.114,P<0.01)。结论感恩、心理弹性在希望与创伤后成长间起中介作用,护理管理者可通过构建基于感恩的干预策略,提高患者家属的心理弹性水平,促进创伤后成长。Objective To understand the status quo of post-traumatic growth of family members of patients with severe neurological diseases,and to analyze the influence of hope,gratitude and resilience on post-traumatic growth.Methods From January to December 2019,340 family members of patients in a neurosurgical intensive care unit of a general tertiary hospital in Shanghai were collected by convenience sampling method. Herth Hope Index,Gratitude Questionnaire-Six-Item Form,Connor-Davidson Resilience Scale and Post-traumatic Growth Inventory were used for investigation them. Results The total post-traumatic growth score of 340 family members of patients with severe neurological disease was(73.38±14.02). The post-traumatic growth of patients’ family members was positively correlated with the levels of hope,gratitude and resilience(r=0.319,0.396 and 0.654,all P<0.01). Bootstrap analysis showed that gratitude and resilience had significant mediating effects on the relationship between hope and posttraumatic growth(95% CI:0.743 ~1.226). It was hoped that gratitude and resilience could positively predict posttraumatic growth (β =0.145,P <0.01;β =0.734,P <0.01),and post-traumatic growth could also be positively predicted through multiple mediators of gratitude sutra resilience (β=0.114,P<0.01). Conclusion Gratitude and resilience play a mediating role in the relationship between hope and post-traumatic growth. Nursing managers can improve the level of mental resilience of patients’ family members and promote post-traumatic growth by constructing gratitude based interventions and education strategies.

关 键 词：重症监护病房 患者家属 希望 感恩 心理弹性 创伤后成长 心理护理 

分 类 号：R473.74[医药卫生—护理学]