心理弹性在稳定期精神分裂症患者病耻感与生存质量间的中介作用  

Intermediary effect of psychological resilience between stigma and quality of life in patients with stable schizophrenia

作　　者：王信 赵威威 祖凤英 陈书燕 刘富英[1] 张燕红[3] Wang Xin;Zhao Weiwei;Zu Fengying;Chen Shuyan;Liu Fuying;Zhang Yanhong(Psychiatry Department,the Affiliated Brain Hospital of Nanjing Medical University,Nanjing 210029,China;School of Nursing,Nanjing Medical University,Nanjing 211166,China;Nursing Department,the Affiliated Brain Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学附属脑科医院精神科,南京210029 [2]南京医科大学护理学院,南京211166 [3]南京医科大学附属脑科医院护理部,南京210029

出　　处：《中华现代护理杂志》2023年第8期997-1003,共7页Chinese Journal of Modern Nursing

基　　金：江苏省医学协会江苏现代医院管理研究中心重点项目(JSYGY-2-2021-411);南京卫生健康委员会科技发展重点项目(ZKA20030);南京医科大学科技发展基金面上项目(NMUB2020238)。

摘　　要：目的探讨稳定期精神分裂症患者病耻感、心理弹性与生存质量之间的关系。方法本研究为横断面研究。采用便利抽样法,于2021年1—12月选取在南京医科大学附属脑科医院门诊就诊的305例稳定期精神分裂症患者为研究对象,采用一般资料调查表、世界卫生组织生存质量简表、心理弹性量表、贬低-歧视感知量表进行调查。采用Pearson相关分析法分析精神分裂症患者生存质量、病耻感和心理弹性的关系,采用AMOS 25.0建立结构方程模型并进行中介效应验证。本研究共发放问卷305份,回收有效问卷286份,有效回收率为93.8%(286/305)。结果286例稳定期精神分裂症患者的心理弹性得分为(56.49±14.28)分,病耻感总分为(29.62±5.70)分,生存质量总分为(63.15±11.67)分;稳定期精神分裂症患者的心理弹性与生存质量得分呈正相关(r=0.461,P<0.01),病耻感与生存质量得分呈负相关(r=-0.328,P<0.01),病耻感与心理弹性得分呈负相关(r=-0.309,P<0.01)。中介效应分析结果显示,心理弹性在病耻感与生存质量之间起部分中介作用,间接作用显著(β=-0.167,P<0.001),中介效应占总效应的百分比为32.2%。结论心理弹性是稳定期精神分裂症患者病耻感与生存质量的中介变量。护理人员应开展以影响心理弹性路径为依据的干预策略,降低患者的病耻感水平,提高其生存质量。Objective To explore the relationship between stigma,psychological resilience and quality of life in patients with stable schizophrenia.Methods This study is a cross-sectional study.From January to December 2021,305 patients with stable schizophrenia who were treated in the Outpatient Department of the Affiliated Brain Hospital of Nanjing Medical University were selected by convenient sampling.The survey was carried out by using the General Information Questionnaire,the World Health Organization Quality of Life-Brief Form(WHOQOL-BREF),the Connor-Davison Resilience Scale(CD-RISC),and the Perceived Devaluation Discrimination(PDD).Pearson correlation analysis was used to analyze the relationship between quality of life,stigma and psychological resilience of schizophrenia patients.The structural equation model was established using AMOS 25.0 and the intermediary effect was verified.A total of 305 questionnaires were distributed and 286 valid questionnaires were recovered,with an effective recovery rate of 93.8%(286/305).Results Among 286 patients with stable schizophrenia,the scores of psychological resilience,stigma and quality of life were(56.49±14.28),(29.62±5.70)and(63.15±11.67)respectively.There was a positive correlation between the psychological resilience and the quality of life(r=0.461,P<0.01),a negative correlation between the stigma and the quality of life(r=-0.328,P<0.01),and a negative correlation between the stigma and the psychological resilience(r=-0.309,P<0.01).The results of intermediary effect analysis showed that psychological resilience played a part of intermediary role between the stigma and the quality of life,and the indirect effect was statistically significant(β=-0.167,P<0.001),the intermediary effect accounted for 32.2%of the total effect.Conclusions Psychological resilience is an intermediary variable between the stigma and the quality of life in patients with stable schizophrenia.Nurses should carry out intervention strategies based on the impact of psychological resilience path to r

关 键 词：精神分裂症 生存质量 病耻感 心理弹性 中介作用 

分 类 号：R749.3[医药卫生—神经病学与精神病学]