炎症性肠病患者疾病接受度在照顾者积极感受与自我管理行为间的中介效应分析  

Mediating effect of acceptance of illness between caregivers′positive feelings and self-management behavior in patients with inflammatory bowel disease

作　　者：郑艳青[1] 王倩[1] 张晓琦[1] 彭春艳[1] 徐新运[2] 杨华[1] ZHENG Yanqing;WANG Qian;ZHANG Xiaoqi;PENG Chunyan;XU Xinyun;YANG Hua(Gastroenterology Department,Drum Tower Hospital Affiliated to Medical School of Nanjing University,Nanjing,Jiangsu,210008;Pathology Department,Drum Tower Hospital Affiliated to Medical School of Nanjing University,Nanjing,Jiangsu,210008)

机构地区：[1]南京大学医学院附属鼓楼医院消化内科,江苏南京210008 [2]南京大学医学院附属鼓楼医院病理科,江苏南京210008

出　　处：《实用临床医药杂志》2023年第19期56-60,共5页Journal of Clinical Medicine in Practice

基　　金：国家自然科学基金资助项目(62006113)。

摘　　要：目的 探讨炎症性肠病(IBD)照顾者积极感受与患者疾病接受度、自我管理行为的关系。方法 采用便利抽样法选取IBD患者214例为研究对象,采用一般资料调查表、照顾者积极感受量表、疾病接受度量表、自我管理行为量表对患者及照顾者进行调查。采用Pearson相关性分析探讨三者的关联性,通过AMOS建立结构方程模型,Bootstrap对模型进行二次检验,分析患者疾病接受度在照顾者积极感受与患者自我管理行为间的中介效应。结果 IBD照顾者积极感受、患者疾病接受度及自我管理行为均处于中等水平。女性照顾者及近2年发作住院次数较多、文化程度较高、工作学习受疾病影响较大的患者的家庭照顾者的积极态度评分较低(P<0.05)。照顾者为女性、年龄较小,疾病处于活动期、近2年发作住院次数较多、工作学习受疾病影响较多的患者疾病接受度较低(P<0.05)。照顾者性别、近2年发作住院次数、工作学习状态均为患者自我管理行为的影响因素(P<0.05)。IBD照顾者积极感受、患者疾病接受度与自我管理行为均呈正相关(r=0.425,P<0.01;r=0.593,P<0.01),患者疾病接受度与自我管理行为亦呈正相关(r=0.607,P<0.01)。中介效应分析显示,患者疾病接受度在照顾者积极感受与患者自我管理行为间具一定程度中介效应。结论 IBD照顾者积极感受、患者疾病接受度对提升患者自我管理行为十分重要。临床医务人员可通过针对性干预,给予患者及照顾者更多的支持途径与疾病管理指导,提升照顾者积极感受与患者疾病接受度,从而提高患者自我管理能力。Objective To explore the relationships of positive feelings of caregivers of inflamma-tory bowel disease(IBD)patients with acceptance of illness and self-management behavior of patients.Methods A total of 214 IBD patients were selected as study subjects by convenience sampling.Pa-tients and caregivers were investigated by general data questionnaire,Caregiver Positive Feeling Scale,Disease Acceptance Scale and Self-management Behavior Scale.Pearson correlation analysis was used to explore the correlation among the three factors,AMOS was used to establish a structural equation model,Bootstrap was used to test the model for the second time,and the mediating effect of patients'disease acceptance between the positive attitude of caregivers and patients'self-management behavior was analyzed.Results The caregiver's positive feelings,acceptance of illness and self-management behaviors of IBD patients were in the middle level.The positive feelings of female caregivers and fami-ly caregivers of IBD patients with more times of hospitalization in recent 2 years,higher education level and work and study more affected by disease were lower(P<0.05).The positive attitude scores of fe-male caregivers and family caregivers of patients with more times of hospitalization in recent two years,higher education level,and greater impact on work and study by disease were lower(P<0.05).The gender of the caregiver,the times of hospitalization in the past two years,and the status of work and study were all influencing factors of patients'self-management behavior(P<0.05).There were positive correlations of IBD caregivers'positive feelings,patients'acceptance of illness with self-management behavior(r=0.425,P<0.01;r=0.593,P<0.01),acceptance of illness was positively correlated with self-management behavior(r=0.607,P<0.01).The mediating effect a-nalysis showed that patients'acceptance of illness had a certain degree of mediating effect between caregivers'positive feelings and patients self-management behavior.Conclusion Positive attitude and ac

关 键 词：炎症性肠病 照顾者 积极态度 疾病接受度 自我管理 

分 类 号：R473[医药卫生—护理学] R547[医药卫生—临床医学]