胆道外科术后患者心理弹性在自我效能与出院准备度间的中介作用  

The Mediating Effect of Psychological Resilience Between Self-efficacy and Readiness for Hospital Discharge in Patients After Biliary Tract Surgery

作　　者：潘晶雪 虞正红 计顺意 PAN Jing-xue;YU Zheng-hong;JI Shun-yi(Department of General Surgery,Zhongshan Hospital of Fudan University,Shanghai 200032,China)

机构地区：[1]复旦大学附属中山医院普外科,上海200032

出　　处：《医学信息》2024年第8期88-94,共7页Journal of Medical Information

基　　金：2020-年复旦大学-复星护理科研基金(编号:FNF202011)。

摘　　要：目的探讨胆道外科术后患者心理弹性、自我效能对出院准备度的影响,分析心理弹性在自我效能与出院准备度间的中介作用。方法本研究为横断面研究,采用便利抽样法,选取2021年10月-2022年6月上海市某三级甲等医院的156例胆道外科术后患者,以自行编制的一般人口学和疾病相关资料、心理弹性量表、自我效能量表和出院准备度量表于出院前4 h对患者进行调查。采用Pearson相关分析探讨各变量间的相关性;采用SPSS的Process插件进行中介效应分析。结果共发放问卷156份,回收有效问卷149份,问卷有效率为95.51%。调查患者年龄为16~85岁,平均(58.85±14.35)岁,其中男67例(44.97%),女82例(55.03%)。婚姻状况、文化程度、现居住地离医院距离远近对胆道外科术后患者心理弹性得分有影响(P<0.05)。胆道外科术后患者出院准备度为(165.51±34.85)分,心理弹性为(70.40±16.01)分,自我效能为(27.93±5.88)分。胆道外科术后患者自我效能与心理弹性呈正相关(r=0.575),心理弹性与出院准备度呈正相关(r=0.556),自我效能和出院准备度呈正相关(r=0.362)。多元逐步回归分析显示,出院带管数量、心理弹性进入回归模型,以上2个自变量可解释胆道外科术后患者出院准备度总变异的41.00%。路径分析表明,心理弹性在自我效能与出院准备度间起到完全中介作用,中介效应占总效应的82.77%。结论胆道外科术后术后患者出院准备度处于较高水平,自我效能对出院准备度的影响是通过心理弹性来实现的,自我效能在影响患者出院准备度过程中,心理弹性起到了完全中介作用。应制定相应的干预措施提高胆道外科术后患者心理弹性,进而提高其出院准备度。Objective To explore the influence of psychological resilience and self-efficacy on readiness for hospital discharge in patients after biliary surgery,and to analyze the mediating effect of psychological resilience between self-efficacy and readiness for hospital discharge.Methods This study was a cross-sectional study.A total of 156 patients after biliary tract surgery in a tertiary hospital in Shanghai from October 2021 to June 2022 were selected by convenient sampling method.The patients were investigated with self-made general demographic and disease-related data,psychological resilience scale,self-efficacy scale and readiness for hospital discharge scale at 4 hours before discharge.Pearson correlation analysis was used to explore the correlation between variables.The Process plug-in of SPSS was used to analyze the mediating effect.Results A total of 156 questionnaires were distributed and 149 valid questionnaires were collected,with an effective rate of 95.51%.The age of the patients was 16-85 years old,with an average of(58.85±14.35)years old,including 67 males(44.97%)and 82 females(55.03%).Marital status,education level,and distance from the hospital to the current place of residence had an impact on the psychological resilience scores of patients after biliary surgery(P<0.05).The readiness for hospital discharge of patients after biliary surgery was(165.51±34.85)scores,the psychological resilience was(70.40±16.01)scores,and the self-efficacy was(27.93±5.88)scores.Self-efficacy was positively correlated with resilience(r=0.575),resilience was positively correlated with readiness for hospital discharge(r=0.556),and self-efficacy was positively correlated with readiness for hospital discharge(r=0.362).Multiple stepwise regression analysis showed that the number of discharged tubes and psychological resilience entered the regression model,and the above two independent variables could explain 41.00%of the total variation of discharge readiness of patients after biliary surgery.Path analysis showed that psy

关 键 词：胆道外科手术 出院准备度 心理弹性 自我效能 中介效应 

分 类 号：R473.6[医药卫生—护理学]