自我效能在慢性阻塞性肺疾病患者社会支持与心理痛苦间的中介效应  

The mediating effect of self-efficacy on the relationship between social support and psychological distress in patients with chronic obstructive pulmonary disease

作　　者：李月琴 周小丽 王琴 邰小丽 于芳 LI Yue-qin;ZHOU Xiao-li;WANG Qin;TAI Xiao-li;YU Fang(Department of Respiratory and Critical Care Medicine,Haian People′s Hospital,Haian 226600,Jiangsu,China)

机构地区：[1]海安市人民医院呼吸与危重症医学科,江苏海安226600

出　　处：《广东医学》2024年第6期763-768,共6页Guangdong Medical Journal

基　　金：江苏省医院协会医院管理创新研究课题(JSYGY-3-2020-733)。

摘　　要：目的了解慢性阻塞性肺疾病(COPD)患者社会支持、自我效能及心理痛苦现状,并探讨三者间的作用关系。方法采用一般资料调查表、COPD自我效能量表(CSES)、社会支持量表(SSRS)和心理痛苦温度计(DT)对2021年11月至2023年4月海安市人民医院呼吸与危重症医学科收治的408例COPD患者进行横断面调查。采用SPSS 25.0软件进行数据统计分析,使用Mplus 7.0软件构建结构方程模型,验证中介效应。结果共发放问卷430份,回收有效问卷408份,有效回收率为94.88%。408例COPD患者CSES总分、SSRS总分和DT总分依次为(92.46±20.73)分、(35.02±9.67)分和(5.92±1.03)分。不同费用支付方式、家庭月收入、病程、近1年因急性发作住院次数的COPD患者DT总分比较,差异均有统计学意义(均P<0.05)。相关性结果显示,COPD患者SSRS总分与CSES总分呈正相关(r=0.415,P<0.01),SSRS总分、CSES总分与COPD患者DT总分均呈负相关(r=-0.617、-0.692,均P<0.01)。结构方程模型结果显示,社会支持对COPD患者心理痛苦的直接效应为-0.524,自我效能在COPD患者社会支持与心理痛苦间的中介效应为-0.218,占总效应的29.38%。结论大部分COPD患者存在中度及以上的心理痛苦,自我效能在COPD患者社会支持与心理痛苦间起中介作用,增强自我效能可进一步减轻COPD患者心理痛苦水平。Objective To understand the current status of social support,self-efficacy,and psychological distress in patients with chronic obstructive pulmonary disease(COPD),and explore the relationships among them.Methods A cross-sectional survey was conducted from November 2021 to April 2023 in the Department of Respiratory and Critical Care Medicine of Haian People′s Hospital,involving 408 COPD patients.General demographic information,the COPD Self-Efficacy Scale(CSES),the Social Support Rating Scale(SSRS),and the Distress Thermometer(DT)were utilized for data collection.Data were statistically analyzed using SPSS 25.0 software,and a structural equation model was constructed using Mplus 7.0 software to validate the mediating effects.Results A total of 430 questionnaires were distributed,and 408 valid questionnaires were collected,yielding an effective response rate of 94.88%.The mean scores for CSES,SSRS,and DT in the 408 COPD patients were(92.46±20.73),(35.02±9.67),and(5.92±1.03)points,respectively.Significant differences were found in DT scores among COPD patients with different payment methods,family monthly income,course of disease,and hospitalizations due to acute exacerbations in the past year(all P<0.05).Correlation analysis revealed a positive correlation between SSRS scores and CSES scores(r=0.415,P<0.01),while both SSRS scores and CSES scores were negatively correlated with DT scores in COPD patients(r=-0.617,-0.692,respectively,both P<0.01).The results of the structural equation model showed that the direct effect of social support on psychological distress in COPD patients was-0.524,and the mediating effect of self-efficacy on the relationship between social support and psychological distress was-0.218,accounting for 29.38%of the total effect.Conclusion Most COPD patients experience moderate to severe psychological distress.Self-efficacy plays a mediating role in the relationship between social support and psychological distress in COPD patients,and enhancing self-efficacy can further alleviate their lev

关 键 词：慢性阻塞性肺疾病 自我效能 社会支持 心理痛苦 中介效应 

分 类 号：R563.9[医药卫生—呼吸系统] R473.5[医药卫生—内科学]