ICU身体约束患者心理弹性水平及影响因素的路径分析  

The levels of psychological resilience and influencing factors path analysis in ICU patients with physical restrain

作　　者：陈巧玲[1] 林如玉 朱宣静 别园园 赵慧玲[1] CHEN Qiaoling;LIN Ruyu;ZHU Xuanjing;BIE Yuanyuan;ZHAO Huiling(Department of Nursing,Fujian Medical University Affiliated Provincial Clinical Medical Institute,FujianP rovincial Hospital,Fuzhou,350001,China;不详)

机构地区：[1]福建医科大学省立临床医学院,福州市350001 [2]福建医科大学护理学院

出　　处：《中华急危重症护理杂志》2024年第1期10-15,共6页Chinese Journal of Emergency and Critical Care Nursing

基　　金：福建省卫健委科技计划项目青年科研课题立项(2021QNA009)。

摘　　要：目的描述ICU身体约束患者心理弹性水平,并探讨其影响因素。方法采用一般资料调查表、心理弹性量表、社会支持评定量表、一般自我效能感量表、医学应对方式问卷、艾森克人格问卷中文简版,选取2021年12月-2022年12月入住福建省某三级甲等医院重症医学科的301例身体约束患者进行调查,采用结构方程模型分析各因素的影响路径。结果ICU身体约束患者心理弹性总分为(53.17±17.41)分,自我效能得分为(25.16±7.96)分,社会支持得分为(38.93±15.12)分,医学应对方式总分为(44.15±15.21)分,艾森克人格总分为(23.68±2.98)分。ICU身体约束患者心理弹性总分与社会支持总分呈正相关(r=0.585,P<0.001),与自我效能总分呈正相关(r=0.545,P<0.01),与医学应对方式面对维度呈正相关(r=0.602,P<0.01),与屈服、回避维度呈负相关(r=-0.567,P<0.01;r=-0.627,P<0.01),与人格特征内外向维度呈正相关(r=0.326,P<0,01),与神经质、精神质和掩饰性得分呈负相关(r=-0.395,P<0.01;r=-0.338,P<0.01;r=-0.362,P<0.01)。构建的模型拟合度良好,其中社会支持对心理弹性存在正向直接效应和间接效应(β=0.546,P<0.001;β=0.267,P<0.001),自我效能对心理弹性存在正向直接效应(β=0.218,P=0.005),医学应对中面对的应对方式对心理弹性存在直接正向效应(β=0.415,P=0.005)、回避的应对方式对心理弹性存在直接负向效应(β=-0.216,P=0.007)、屈服的应对方式对心理弹性存在直接负向效应(β=-0.431,P<0.001);人格特征对心理弹性具有负向影响(β=-0.606,P<0.001)。结论ICU身体约束患者的心理弹性总体水平偏低。社会支持、自我效能、应对方式、人格特征是ICU身体约束患者心理弹性的重要影响因素,可从这4项因素切入针对性干预提高身体约束患者的心理弹性水平。Objective To describe the level of psychological resilience in ICU physically restrained patients and to explore the influencing factors.Methods A general information questionnaire,Connor-Davidson Resilience Scale,Social Support Rating Scale,General Self-Efficacy Scale,Medical Coping Modes Questionnaire,and the Chinese short version of the Eysenck Personality Questionnaire were used to investigate 301 physically restrained patients admit-ted to the Department of Intensive Care Medicine of a tertiary class A hospital in Fujian Province from December 2021 to December 2022.Structural equation modelling was used to conduct the path analyses for the various influ-encing factors.Results Total psychological resilience score of ICU physically restrained patients was(53.17±17.41),self-efficacy score was(25.16±7.96),social support score was(38.93±15.12),medical coping total score was(44.15±15.21),and Eysenck's personality total score was(23.68±2.98).The total psychological resilience score of ICU physically restrained patients was positively correlated with the total social support score(r=0.585,P<0.001),positively correlated with the total self-efficacy score(r=0.545,P<0.01),positively correlated with the confrontation dimension of the medical coping styles(r=0.602,P<0.01),and negatively correlated with the yielding and avoidance dimensions(r=-0.567,P<0.01;r=-0.627,P<0.01),positively correlated with the introversion and extroversion dimen-sions of personality traits(r=0.326,P<0.01),and negatively correlated with neuroticism,psychoticism,and dissimulation scores(r=-0.395,P<0.01;r=-0.338,P<0.01;r=-0.362,P<0.01).The model was well-fitted,social support had direct and indirect effects on psychological resilience(r=0.546,P<0.001;r=0.267,P<0.001),self-efficacy had a direct effect onpsychological resilience(r=0.218,P<0.001).Confrontation coping style had a direct positive effect on psychological resilience(r=0.415,P<0.001),avoidance coping style had a direct negative effect(r=-0.216,P=0.007)and resignation coping style had

关 键 词：约束 身体的 弹性 心理 因素分析 统计学 危重病护理 

分 类 号：R473[医药卫生—护理学]