二元应对和益处发现在糖尿病患者痛苦与睡眠质量间的链式中介作用  

The chain mediating role of dyadic coping and benefit finding in the relationship between diabetes distress and sleep quality in type 2 diabetes patients

作　　者：杜伟[1] 高俊香[2] 王磊磊[1] 耿婉露 王红红[1] 张冰倩[3] Du Wei;Gao Jun-xiang;Wang Leilei;Geng Wanlu;Wang Honghong;Zhang Bingqian(Department of Endocrinology,The Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院内分泌科,河北石家庄050000 [2]河北医科大学第二医院护理部,河北石家庄050000 [3]河北医科大学第二医院心身医学科,河北石家庄050000

出　　处：《护理学杂志》2024年第17期50-54,共5页Journal of Nursing Science

基　　金：2019年河北省财政厅老年病防治项目(361004)。

摘　　要：目的探讨糖尿病痛苦对2型糖尿病患者睡眠质量的影响,以及二元应对、益处发现在其中的中介作用。方法采用一般情况调查表、糖尿病痛苦量表、二元应对问卷、益处发现评定量表和匹兹堡睡眠质量指数量表对221例2型糖尿病患者进行问卷调查。建立中介效应的结构方程模型并采用Bootstrap法检验中介效应。结果2型糖尿病患者糖尿病痛苦、二元应对、益处发现和睡眠质量得分分别为(29.75±13.94)分、(116.20±21.67)分、(34.94±11.98)分、4.00(2.00,8.00)分。中介效应分析表明,糖尿病痛苦能直接预测睡眠质量,直接效应占总效应的52.0%,二元应对、益处发现及两者的链式中介作用间接影响睡眠质量,中介效应分别占总效应的18.4%、16.0%、13.6%。结论糖尿病痛苦对2型糖尿病患者睡眠质量有直接预测作用,二元应对和益处发现在两者间有中介作用。通过加强2型糖尿病患者二元应对和益处发现水平,可减轻糖尿病痛苦对患者睡眠质量的影响。Objective To construct chain mediation models to examine whether dyadic coping and benefit finding mediate the effects of diabetes distress on sleep quality in patients with type 2 diabetes.Methods A convenience sample of 221 patients with type 2 diabetes were surveyed by using a demographic questionnaire,the Diabetes Distress Scale,the Dyadic Coping Inventory,the Benefit Finding Scale and the Pittsburgh Sleep Quality Index.Results The scores of diabetes distress,dyadic coping,benefit finding and sleep quality were 29.75±13.94,116.20±21.67,34.94±11.98,4.00(2.00,8.00),respectively.The effects of diabetes distress had a direct link on sleep quality,with the direct effect accounting for 52.0%of the total effect,and had three indirect paths on sleep quality:the independent mediating role of dyadic coping was 18.4%,the independent mediating role of benefit finding was 16.0%,as well as the completely chain mediating role of dyadic coping and benefit finding was 13.6%.Conclusion Dyadic coping and benefit finding are part of a causal chain between the effects of diabetes distress and sleep quality among patients with type 2 diabetes.By enhancing dyadic coping and benefit finding in patients with type 2 diabetes,the effect of diabetes distress on sleep quality can be attenuated.

关 键 词：2型糖尿病 糖尿病痛苦 睡眠质量 二元应对 益处发现 中介作用 

分 类 号：R473.5[医药卫生—护理学] R587.1[医药卫生—临床医学]