痛风患者生命质量影响因素作用机制的预测分析:基于Wilson-Cleary模式  

A predictive analysis of influencing factors with quality of life among patients with gout:based on Wilson-Cleary model

作　　者：张嫣然 苗秀欣[1] 刘婷[1] 李长贵[2] 王灿[2] 燕菊 Zhang Yanran;Miao Xiuxin;Liu Ting;Li Changgui;Wang Can;Yan Ju(School of Nursing,Qingdao University,Qingdao 266021,China;Shandong Provincial Key Laboratory of Metabolic Disease,the Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学护理学院,266021 [2]青岛大学附属医院山东省代谢性疾病重点实验室,266003

出　　处：《中国实用护理杂志》2021年第35期2734-2740,共7页Chinese Journal of Practical Nursing

基　　金：青岛市科技惠民项目(20-3-4-48-nsh);山东省研究生教学质量提升计划项目(鲁学位[2017]1号)。

摘　　要：目的调查痛风患者疼痛、功能障碍、自我效能、社会支持水平现状及痛风患者健康相关生命质量现状,分析其对痛风患者健康相关生命质量的影响及作用机制。方法2019年11月至2020年1月采用便利抽样法,选取青岛大学附属医院山东省代谢性疾病重点实验室收治的218例痛风患者,通过一般情况调查表、疼痛视觉模拟评分、健康评定量表残疾指数、一般自我效能量表、领悟社会支持量表、痛风影响量表对纳入的研究对象进行调查。运用AMOS 24.0建立结构方程模型进行路径分析并检验痛风患者疼痛、功能障碍、自我效能、社会支持影响生命质量的作用机制。结果痛风患者痛风影响程度、疼痛、功能障碍、自我效能、社会支持总分依次为(59.94±18.39)、(6.00±2.76)、0.25(0,0.88)、(23.39±6.40)、(62.92±8.24)分。疼痛对生命质量有直接负向预测作用(β=-0.293,P<0.05),并通过功能障碍间接影响生命质量(β=-0.039,P<0.05);功能障碍对痛风患者生命质量有直接负向预测作用(β=-0.244,P<0.05);自我效能对生命质量有直接正向预测作用(β=0.182,P<0.05),并通过疼痛、功能障碍对生命质量产生间接正向预测作用(β=0.202,P<0.05);社会支持通过疼痛、功能障碍、自我效能对生命质量产生间接正向预测作用(β=0.278,P<0.05)。结论痛风对患者的生命质量影响较大,疼痛、功能障碍、自我效能、社会支持通过不同的作用路径直接或间接影响其生命质量,且这些变量间存在交互作用。医护人员可采取针对性干预措施缓解患者的疼痛症状,预防和减缓功能障碍,提高痛风患者的自我效能,增加社会支持,以改善痛风患者生命质量。Objective To explore the impact of pain,functional disability,self-efficacy and social support on health-related quality of life(HRQOL)in gout patients.Methods From November 2019 to January 2020,a total of 218 patients with gout were investigated using the general information questionnaire,Visual Analogue Scale,Health Assessment Questionnaire Disability Index,General Self-Efficacy Scale,Perceived Social Support Scale,and Gout Impact Scale.The structural equation model was established by AMOS 24.0 for parth analysis,and the mechanism of pain dysfuction,self-efficacy and social support affecting the quality of life in gout patients was tested.Results The total score of Gout Impact Scale,pain,functional disability,self-efficacy and social support respectively was 59.94±18.39,6.00±2.76,0.250,0.88,23.39±6.40 and 62.92±8.24.Pain directly influenced HRQOL(β=-0.293,P<0.01),and indirectly influenced HRQOL(β=-0.039,P<0.05).Functional disability directly influenced HRQOL(β=-0.244,P<0.01).Self-efficacy directly influenced HRQOL(β=0.182,P<0.01),and indirectly influenced HRQOL(β=0.202,P<0.01)through pain and functional disability.Social support indirectly influenced HRQOL(β=0.278,P<0.01)through pain,functional disability and self-efficacy.Conclusions HRQOL of patients among gout is affected by several factors,mainly affected by pain,functional disability and self-efficacy;and there are interactions among them.Targeted interventions should be strengthened to relieve pain,prevent or slow down the progress of physical disability,enhance self-efficacy and social support to improve HRQOL.

关 键 词：痛风 生活质量 疼痛 功能障碍 自我效能 社会支持 

分 类 号：R589.7[医药卫生—内分泌]