中老年维持性血液透析病人与照顾者衰弱、心理韧性对应对方式的主客体互倚模型分析  

Frailty and resilience on coping styles of middle⁃aged and elderly maintenance hemodialysis patients and caregivers:an Actor⁃Partner Interdependence Model analysis

作　　者：杨玉霖 高欢玲[2] 尚春娥 宋歌 李红梅[2] 陈玲[1] YANG Yulin;GAO Huanling;SHANG Chun'e;SONG Ge;LI Hongmei;CHEN Ling(Graduate School of Shanxi Medical University,Shanxi 030001 China)

机构地区：[1]山西医科大学研究生院,山西030001 [2]山西医科大学汾阳学院 [3]山西省汾阳医院

出　　处：《护理研究》2022年第20期3619-3623,共5页Chinese Nursing Research

基　　金：吕梁市科技计划项目(临床护理研究重点实验室课题),编号:吕梁发〔2020〕33号;山西医科大学汾阳学院2020年度院级科研项目,编号:2020B08。

摘　　要：目的:基于主客体互倚模型(APIM)分析中老年维持性血液透析(MHD)病人和主要照顾者衰弱、心理韧性对积极应对方式的影响。方法:便利抽取山西省2所三级甲等医院门诊中老年MHD病人及其主要照顾者246对作为研究对象,采用一般资料调查表、Tilburg衰弱量表、心理韧性量表和简易应对方式问卷进行调查,建立衰弱、心理韧性对积极应对方式的APIM。结果:MHD病人与主要照顾者衰弱发生率及心理韧性、积极应对得分比较差异有统计学意义(P<0.05),MHD病人衰弱与主要照顾者衰弱呈正相关(P<0.01),与心理韧性、积极应对呈负相关(P<0.01)。MHD病人的心理韧性、积极应对与主要照顾者衰弱呈负相关(P<0.01),与心理韧性、积极应对呈正相关(P<0.01)。主体效应方面,中老年MHD病人及其主要照顾者衰弱、心理韧性水平均可影响自身的积极应对方式(P<0.001);客体效应方面,二者的衰弱均可影响对方的积极应对(P<0.05或P<0.001),同时病人的心理韧性可影响主要照顾者的积极应对(P<0.001)。结论:MHD病人及其主要照顾者的积极应对与两者衰弱、心理韧性存在交互影响,提示临床工作者应及时甄别和干预二者的衰弱与心理韧性,积极探索更具针对性的干预方案,建立积极的应对方式。Objective:Based on the Actor⁃Partner Interdependence Model(APIM),to analyze the effects of frailty and resilience on positive coping styles in middle⁃aged and elderly maintenance hemodialysis(MHD)patients and their primary caregivers.Methods:A convenient selection of 246 pairs of middle⁃aged and elderly MHD patients and their main caregivers in outpatient clinics of 2 tertiary hospitals in Shanxi province were used as the research subjects.The general information questionnaire,Tilburg Frailty Indicator(TFI),Connor and Davidson's Resilience Scale(CD⁃RISC),and Simple Coping Style Questionnaire(SCSQ)were used to investigate and build the APIM for frailty and resilience versus positive coping styles.Results:There were statiscically significant differences in the incidence of frailty,resilience and positive coping between MHD patients and their primary caregivers(P<0.05).The frailty of MHD patients was positively correlated with the frailty of the primary caregiver(P<0.01);it was negatively correlated with resilience and positive coping(P<0.01).The resilience and active coping styles of MHD patients were negatively correlated with the frailty of the main caregiver(P<0.01),which was positively correlated with resilience and positive coping styles(P<0.01).In terms of subject effect,the level of frailty(P<0.001)and resilience(P<0.001)of middle⁃aged and elderly MHD patients and their primary caregivers could affect their positive coping style.In terms of object effect,the frailty of both could affect the other's performance of positive coping styles(P<0.05 or P<0.01),while the patient's resilience could affect the positive coping styles of the primary caregiver(P<0.001).Conclusions:The active coping styles of MHD patients and their primary caregivers had an interactive effect on their frailty and resilience.It suggested that clinicians should identify and intervene in the frailty and resilience of the patients and their caregivers in time and actively explore more targeted intervention programs to build positive

关 键 词：主客体互倚模型 维持性血液透析 病人 照顾者 衰弱 心理韧性 积极应对 影响因素 

分 类 号：R473.5[医药卫生—护理学]