基于应激-易感模型的青少年系统性红斑狼疮患者自杀意念相关因素分析  

Factors associated with suicidal ideation in adolescents with systemic lupus erythematosus based on the stress-susceptibility model

作　　者：张莉[1] 莫霖[2] 刘洋[3] 陶静 余璐[2] Zhang Li;Mo Lin;Liu Yang;Tao Jing;Yu Lu(Emergency Department,Children’s Hospital of Chongqing Medical University,National Clinical Research Center for Child Health and Disorders,Ministry of Education Key Laboratory of Child Development and Disorders,Chongqing Municipal Key Laboratory of Child Neurodevelopmental and Cognitive Disorders;Outpatient Clinic of Children’s Hospital of Chongqing Medical University;Nursing Department,Children’s Hospital of Chongqing Medical University;Department of Rheumatology and Immunology,Children’s Hospital of Chongqing Medical University)

机构地区：[1]重庆医科大学附属儿童医院急诊科,国家儿童健康与疾病临床医学研究中心,儿童发育疾病研究教育部重点实验室,儿童神经发育与认知障碍重庆市重点实验室 [2]重庆医科大学附属儿童医院门诊部 [3]重庆医科大学附属儿童医院护理部 [4]重庆医科大学附属儿童医院风湿免疫科,重庆400014

出　　处：《重庆医科大学学报》2025年第1期105-113,共9页Journal of Chongqing Medical University

基　　金：重庆市科技计划资助项目(编号:CSTB2022NSCQ-MSX0082;CSTB2023NSCQ-MSX0567)。

摘　　要：目的:基于应激-易感模型,探讨疾病活动度、家庭功能、负性情绪、社会支持与自杀意念的关系及机制。方法:采用一般资料调查表、自杀意念量表、家庭功能评估量表、抑郁-焦虑-压力量表、社会支持评定量表及系统性红斑狼疮疾病活动指数评分对180例青少年系统性红斑狼疮患者进行调查。结果:青少年系统性红斑狼疮患者自杀意念检出率为22.22%。自杀意念与疾病活动度、负性情绪均呈正相关,与家庭功能呈负相关。负性情绪在疾病活动度、家庭功能与自杀意念中发挥中介作用,中介效应占总效应的百分比分别为44.45%、20.66%。社会支持在疾病活动度与负性情绪间起调节作用,即社会支持水平越高,疾病活动度对负性情绪的正向预测作用就越弱。结论:青少年系统性红斑狼疮患者疾病活动度、家庭功能可直接或通过负性情绪间接影响其自杀意念,并受社会支持的调节。医务人员可以通过提高患者的家庭功能和社会支持水平,控制疾病活动,降低其负性情绪,进而降低其自杀意念的产生。Objective:To investigate the association of disease activity,family functioning,negative emotion,and social support with suicidal ideation based on the stress-susceptibility model.Methods:The General Information Questionnaire,Suicidal Ideation Scale,Family Functioning Assessment Scale,Depression-Anxiety-Stress Scale,Social Support Rating Scale,and systemic lupus erythematosus(SLE)disease activity index score were used to conduct an investigation among 180 adolescent SLE patients.Results:The detection rate of suicidal ideation was 22.22%in adolescent SLE patients.Suicidal ideation was positively correlated with disease activity and negative emotion and was negatively correlated with family functioning.Negative emotion played a mediating role between disease activity/family functioning and suicidal ideation,and the mediating effect accounted for 44.45%and 20.66%,respectively,of the total effect.Social support played a moderating role between disease activity and negative emotion,i.e.,the higher the level of social support,the weaker the positive predictive effect of disease activity on negative emotion.Conclusion:Disease activity and family functioning in adolescent SLE patients can influence their suicidal ideation directly or indirectly through negative emotion and are moderated by social support.Healthcare professionals can control disease activity and reduce negative emotion by improving the family functioning of patients and the level of social support,which in turn reduces the development of suicidal ideation.

关 键 词：系统性红斑狼疮 青少年 自杀意念 应激-易感模型 

分 类 号：R473.72[医药卫生—护理学]