老年期痴呆患者照顾者的病耻感对就医决策时长的影响路径及人文关怀对策  

The influence path of stigma on the time of healthcare-seeking decision in caregivers of elderly patients with dementia and humanistic care strategies

作　　者：昝畅 周芳 李斌 汤胜男 张琼琼 王庆妍 Zan Chang;Zhou Fang;Li Bin;Tang Shengnan;Zhang Qiongqiong;Wang Qingyan(Department of Nursing,the Affiliated Hospital of Xuzhou Medical University,Xuzhou 221006,China;Department of Clinical Nursing,School of Nursing,Xuzhou Medical University,Xuzhou 221004,China;Department of Geriatric Psychiatry,Xuzhou Oriental People's Hospital,Xuzhou 221004,China)

机构地区：[1]徐州医科大学附属医院护理部,徐州221006 [2]徐州医科大学护理学院临床护理教研室,徐州221004 [3]徐州市东方人民医院老年精神科,徐州221004

出　　处：《中国实用护理杂志》2022年第30期2333-2339,共7页Chinese Journal of Practical Nursing

基　　金：江苏省教育厅高校哲学社会科学研究专题项目(2019SJA0944);江苏省研究生科研与实践创新计划(SJCX21_1158);江苏省科技项目(BK20201016);徐州市推动科技创新专项资金(KC19140);江苏高校自然科学研究面上项目(20KJB320036)。

摘　　要：目的明确老年期痴呆患者照顾者的病耻感对就医决策时长的影响程度及影响路径,为构建相应人文关怀策略的内容提供理论基础。方法采用方便抽样法,选取2021年2月至2022年2月在徐州医科大学附属医院和徐州市东方人民医院就诊的176名老年期痴呆患者照顾者作为研究对象。采用患者及照顾者一般资料调查表、自设老年期痴呆患者照顾者病耻感量表、多维领悟社会支持量表、自设老年期痴呆患者照顾者就医决策感知障碍量表、自设老年期痴呆患者照顾者就医意向量表进行问卷调查。运用AMOS 20.0建立结构方程模型进行路径分析。结果老年期痴呆患者照顾者的病耻感越高,就医决策时长越长(β=0.05,P<0.05);社会支持、就医决策感知障碍和就医意向是照顾者病耻感影响就医决策时长的中介变量,对就医决策时长的总作用大小分别为-0.04、0.14和0.36,均P<0.05。结论老年期痴呆患者照顾者病耻感是影响就医决策时长的重要因素,通过改善其中介因素社会支持、就医决策感知障碍、就医意向,实施针对性的人文关怀策略有望为缩短就医决策时长提供帮助。Objective To clarify the influence and influence paths of stigma on the time of the healthcare-seeking decision in caregivers of elderly patients with dementia,and to provide a theoretical basis for the construction of corresponding humanistic care strategies.Methods A total of 176 caregivers of elderly patients with dementia who visited the Affiliated Hospital of Xuzhou Medical University and Xuzhou Oriental People's Hospital from February 2021 to February 2022 were selected as the study subjects.The General Information Questionnaire,self-designed Scale of Stigma for Caregivers of Senile dementia patients,Multidimensional Scale of Perceived Social Support,self-designed Elderly Dementia Caregivers'Perceived Barriers Scale for Healthcare-seeking Decision,and self-designed Scale of the Intention to Seek Healthcare for caregivers of senile dementia patients were used in the survey.AMOS 20.0 was used to establish a structural equation model for path analysis.Results The higher the stigma of caregivers,the longer the time of the healthcare-seeking decision(β=0.05,P<0.05).Social support,perceived barriers to the healthcare-seeking decision,and the intention to seek healthcare were the mediating variables of caregivers'stigma affecting the time of the healthcare-seeking decision,with a total effect of-0.04,0.14,and 0.36,respectively,and all P<0.05.Conclusions The stigma in caregivers of senile dementia patients is an important factor affecting the time of the healthcare-seeking decision.By improving mediating factors including social support,perceived barriers to the healthcare-seeking decision,and the intention to seek healthcare,the implementations of targeted humanistic care strategies are expected to help shorten the time of the healthcare-seeking decision.

关 键 词：老年期痴呆 病耻感 照顾者 就医决策 

分 类 号：R473.74[医药卫生—护理学]