恶性血液病患者自我效能对抑郁的影响:社会支持的中介作用与心理弹性的调节作用  

Effect of self-efficacy on depression in patients with hematologic malignancy: the mediating role of social support and the moderating effect of resilience

作　　者：曹旭然 张阔[2] 杜亚欣 刘传新[1] Cao Xuran;Zhang Kuo;Du Yaxin;Liu Chuanxin(School of Mental Health,Jining Medical University,Jining 272067,China;Zhou Enlai School of Government,Nankai University,Tianjin 300071,China;Department of Psychology,Tianjin Normal University,Tianjin 300387,China)

机构地区：[1]济宁医学院精神卫生学院,济宁272067 [2]南开大学周恩来政府管理学院,天津300071 [3]天津师范大学心理学部,天津300387

出　　处：《中华行为医学与脑科学杂志》2023年第5期420-425,共6页Chinese Journal of Behavioral Medicine and Brain Science

基　　金：山东省研究生教育教学改革项目(SDYJG19212);济宁医学院贺林院士新医学临床转化工作站科研基金(JYHL2021ZD02)。

摘　　要：目的探讨恶性血液病患者自我效能感与抑郁之间的关系,分析社会支持的中介作用以及心理弹性的调节作用。方法2017年2—6月,采用心理弹性量表(Connor-Davidson resilience scale,CD-RISC)、社会支持量表(social support rate scale,SSRS)、一般自我效能感量表(general self-efficacy scale,GSES)、抑郁自评量表(self-rating depression scale,SDS),对济宁医学院附属医院284名恶性血液病患者进行问卷调查,采用SPSS 21.0软件进行Pearson相关分析、PROCESS v3.4宏程序进行中介效应和调节效应检验。结果恶性血液病患者自我效能感对抑郁有显著负向预测作用(β=-0.35,t=-6.16,P<0.01);社会支持在自我效能感与抑郁的关系中起到部分中介作用,中介效应量为-0.05,占总效应的14.29%(-0.05/-0.35);心理弹性调节了社会支持在自我效能感与抑郁关系中的中介作用,具体表现为心理弹性水平较低时,自我效能感对社会支持没有预测作用,而当心理弹性水平较高时,自我效能感对社会支持存在显著负向预测作用(简单斜率=-0.28,P<0.01,95%CI=-0.39~-0.18)。结论恶性血液病患者的自我效能感对抑郁的影响是有调节的中介效应,自我效能感通过社会支持影响抑郁,心理弹性可调节社会支持在自我效能感与抑郁关系间的中介作用。Objective To explore the correlation between self-efficacy and depression in patients with hematologic malignancy,and analyze the mediating role of social support and the moderating effect of resilience.Methods From February to June 2017,a total of 284 patients with hematologic malignancy in Jining Medical University Affiliated Hospital completed Connor-Davidson resilience scale(CD-RISC),social support rate scale(SSRS),general self-efficacy scale(GSES),self-rating depression scale(SDS).SPSS 21.0 software was used for statistical analysis,and the correlation was obtained by Pearson correlation analysis,and PROCESS v3.4 macro program was used to test the mediating and moderating effects.Results Self-efficacy played a significant negatively predictive effect on depression in patients with hematologic malignancy(β=-0.35,t=-6.16,P<0.01).Social support partially mediated the correlation between self-efficacy and depression(the mediating effect was-0.05,accounted for 14.29%(-0.05/-0.35)of the total effect).Resilience moderated the mediating effect of social support on the correlation between self-efficacy and depression.The self-efficacy had no predictive effect on social support when the level of resilience was low and it had a significant negatively predictive effect on social support when the level of resilience was high(simple slope=-0.28,P<0.01,95%CI=-0.39--0.18).Conclusion Self-efficacy has a moderating effect on depression in patients with hematologic malignancy.Self-efficacy affects depression through social support,and resilience regulates the mediating role of social support in the relationship between self-efficacy and depression.

关 键 词：恶性血液病 心理弹性 社会支持 自我效能感 抑郁 

分 类 号：R733[医药卫生—肿瘤]