家庭功能对缺氧缺血性脑病新生儿照护者照护负担与心理弹性的中介效应研究  

Mediating effect of family function on relationship between care burden and resilience of hypoxic-ischemic encephalopathy infants

作　　者：李欣颖[1] 张中翠 刘志瑜 肖小梅[1] 向霜 LI Xinying;ZHANG Zhongcui;LIU Zhiyu;XIAO Xiaomei;XIANG Shuang(Department of Pediatrics,Dazhou Hospital of Integrated Traditional Chinese and Western Medicine,Dazhou,Sichuan 635000,China)

机构地区：[1]达州市中西医结合医院儿科,四川达州635000

出　　处：《新疆医科大学学报》2022年第1期121-126,共6页Journal of Xinjiang Medical University

基　　金：四川省中医药管理局科学技术研究专项课题(2020LC0101)。

摘　　要：目的研究家庭功能对新生儿缺氧缺血性脑病(HIE)主要照护者照护负担与心理弹性的中介效应。方法选取2019年1月-2021年1月在达州市中西医结合医院儿科住院治疗的100例足月HIE患儿的主要照护者为研究对象。采用问卷调查法调查足月HIE患儿主要照护者一般资料;采用家庭关怀度指数问卷(APGAR)评估主要照护者家庭功能;依据心理弹性量表(CD-RISC)评估主要照护者心理弹性;依据Zarit照护负担量表评估主要照护者照护负担水平;根据APGAR评分将主要照护者分为家庭功能良好组(n=65)、家庭功能障碍组(n=35),分析并比较两组主要照护者心理弹性、照护负担评分;采用Pearson相关性分析分析三量表各维度得分之间的相关性;采用Amos24.0进行结构方程模型构建及中介效应的分析。结果主要照护者家庭功能总分为(7.74±1.11)分,照护负担总分为(38.26±5.75)分,心理弹性总分为(62.58±12.15)分;与家庭功能良好组比较,家庭功能障碍组主要照护者的照护负担评分(25.85±4.97分vs.50.76±6.49分)总分升高,心理弹性评分降低(75.29±12.57分vs.49.87±10.48分,P<0.05);Pearson相关性分析结果显示,照护负担中的失控、愤怒维度与家庭功能中的各维度均呈负相关(P<0.05),照护负担中的依赖性维度与家庭功能中的亲密度维度呈负相关(P<0.05);心理弹性中的自强、坚韧、乐观维度与家庭功能中的各维度均呈正相关(P<0.05)。Amos24.0结构方程模型构建及中介效应分析显示,主要照护者家庭功能、心理弹性β值分别为-0.331、-0.278,表明主要照护者家庭功能、心理弹性对照护负担有负向影响;家庭功能对心理弹性有正向作用,标准化系数为0.68;家庭功能对照顾负担有负相作用,标准化系数为-0.52;心理有弹性对照护负担有负向作用,标准化系数为-0.39。结论家庭功能在心理弹性和照护负担中起到一定中介效应,家庭功能是影响照护者照Objective To explore the mediating effect of family function on relationship between nursing burden and mental resilience of the main caregivers of infants with term newborns hypoxic ischemic encephalopathy(HIE).Methods The main caregivers of 100 full-term HIE children hospitalized in pediatrics of the hospital from January 2019 to January 2021 were selected as the research object.The general data of main caregivers of full-term HIE children were investigated by questionnaire.The index questionnaire of family care(APGAR)was used to evaluate family function of the main caregivers;The mental resilience of the primary caregivers were evaluated according to the Mental Resilience Scale(CD-RISC).The level of care burden of the primary caregivers were evaluated according to Zarit care burden scale.According to APGAR score,the main caregivers were divided into the good family function group(n=65)and the family dysfunction group(n=35),Pearson correlation analysis was used to analyze the correlation between the scores of the each dimension in three scales;Amos24.0 was used to construct the structural equation model and analyze the mediating effect.Results The total score of family function,the total score of care burden and care burden were(7.74±1.11)points,(38.26±5.75)points and(62.58±12.15)points respectively.Compared with the group with good family function,the score of care burden of the main caregivers in the family dysfunction group was(25.85±4.97 points vs.50.76±6.49 points)and the resilience score(75.29±12.57 points vs.49.87±10.48 points,P<0.05).The out-of-control and the anger dimensions of care burden were negatively correlated with the dimensions of family functioning(P<0.05).The dependency dimension in the care burden was negatively correlated with the intimacy dimension in family function(P<0.05).The construction of amos24.0 structural equation model and intermediary effect analysis showed the family function and psychological elasticity of the main caregivers β values were-0.331 and-0.278 respectively

关 键 词：足月儿缺氧缺血性脑病 主要照护者 家庭功能 照护负担 心理弹性 中介效应 

分 类 号：R473.72[医药卫生—护理学]