癌症患者及其配偶二元应对与心理弹性的主体-客体互倚模型研究  

Relationship between Dyadic Coping and Psychological Resilience in Cancer Survivor Couples: An Actor-partner Interdependence Model-based Analysis

作　　者：孙海燕 秦阳 徐益荣 陈文艳 SUN Hai-yan;QIN Yang;XU Yi-rong;CHEN Wen-yan(School of Nursing,Jiangsu Vocational College of Medicine,Yancheng 224005,China)

机构地区：[1]江苏医药职业学院护理学院,江苏盐城224005

出　　处：《护理学报》2022年第6期60-64,共5页Journal of Nursing（China）

基　　金：江苏省高校哲学社会科学研究项目(2021SJA1944);江苏省高职院校教师专业带头人高端研修项目(苏高职培函[2020]10号)。

摘　　要：目的 探讨癌症患者和配偶的二元应对与心理弹性的关系,为临床干预提供理论依据。方法 采取便利抽样法,选取盐城4所三级医院的371对癌症患者及其配偶为研究对象,采用二元应对量表、心理弹性量表进对其行调查。基于主体-客体互倚模型分析癌症患者和配偶间二元应对与心理弹性的关系。结果 癌症患者二元应对总分为(62.40±14.08)分,癌症患者配偶总分为(61.83±15.10)分。癌症患者心理弹性总分为(62.36±13.11)分,癌症患者配偶总分为(60.47±12.80)分。癌症患者及其配偶的二元应对与自身及对方的心理弹性得分均呈正相关(r=0.312~0.739,均P<0.001)。癌症患者及其配偶的二元应对都能够正向影响自身的心理弹性(β=0.616,0.700;均P<0.001),即主体效应显著。癌症患者及其配偶的二元应对都能够正向影响对方的心理弹性(β=0.330,0.651;均P<0.001),即客体效应显著。结论 癌症患者及其配偶的心理弹性受自身和对方支持应对行为的交互影响。医护人员应将癌症夫妻视为一个共同体,有助于制订以夫妻为中心的相互支持应对策略,从而减少应对癌症时的心理压力。Objective To examine the relationship between dyadic coping and psychological resilience in cancer survivors and their spouses, and to provide theoretical basis for clinical intervention. Methods With convenience sampling, a total of 371 cancer survivors and their spouses were recruited from four tertiary hospitals in Yancheng City. Dyadic Coping Inventory and Connor-Davidson Resilience Scale were used to assess dyadic coping style and psychological resilience. The actor-Partner interdependence model was used to explore the association between dyadic coping and psychological resilience. Results The total score of dyadic coping of cancer patients was 62.40 ±14.08, and that in their spouses 61.83 ±15.10. The total score of psychological resilience of cancer patients and their spouses was 62.36±13.11, and 60.47±12.80 respectively. The total score of dyadic coping in cancer patients and their spouses was positively correlated with psychological resilience(r=0.312~0.739, all P<0.001). In terms of actor-effect, the score of dyadic coping in cancer patients and their spouses was positively correlated with their own psychological resilience score respectively(β=0.616, β=0.700, all P<0.001). In terms of partner-effect, the score of dyadic coping in cancer patients and their spouses was positively correlated with the counterparts’ score of psychological resilience respectively(β=0.330, β=0.651, all P<0.001).Conclusion The psychological resilience of cancer survivors and their couples is affected by individual and the dyadic supportive coping. Patients and their caregivers should be viewed as a unit, and couple-centered positive coping strategies to reduce their psychological distress with cancer should be implemented.

关 键 词：癌症 配偶 二元应对 心理弹性 主体-客体互倚模型 

分 类 号：R473.73[医药卫生—护理学]