自我效能和心理韧性在神经根型颈椎病患者自我管理与术后康复间的中介效应  

The mediation effect of self-efficacy and mental toughness on self-management and postoperative rehabilitation in patients with cervical spondylotic radiculopathy

作　　者：黄芳[1] 刘齐芳 谌美清 喻春梅[1] 李如兵 HUANG Fang;LIU Qifang;SHEN Meiqing;YU Chunmei;LI Rubing(Department of Rehabilitation Medicine,the First Hospital of Nanchang,Nanchang 330000,Jiangxi,China;Department of CardiologyⅠ,the First Hospital of Nanchang,Nanchang 330000,Jiangxi,China)

机构地区：[1]南昌市第一医院康复医学科,江西南昌330000 [2]南昌市第一医院心内一科,江西南昌330000

出　　处：《中国现代医生》2025年第4期16-19,39,共5页China Modern Doctor

基　　金：江西省卫生健康委科技计划项目(202211578)。

摘　　要：目的分析自我效能和心理韧性在神经根型颈椎病患者自我管理与术后康复间的链式中介效应。方法采用便利抽样法选取2022年4月至2024年4月南昌市第一医院诊治的神经根型颈椎病患者180例,采用一般资料调查问卷、Connor-Davidson心理弹性量表(Connor-Davidson resilience scale,CD-RISC)、慢性病自我效能量表(chronic disease self-efficacy scale,CDES)、神经根型颈椎病康复评价量表(rehabilitation evaluation scale for cervical spondylotic radiculopathy,RES-CSR)、慢性病自我管理量表(chronic disease self-management scale,CDSMS)对患者进行调查。结果神经根型颈椎病患者的CD-RISC评分为(64.41±10.12)分,RES-CSR评分为(78.84±12.07)分,CDES评分为(41.26±3.18)分,CDSMS评分为(53.14±6.38)分。相关性分析结果显示,神经根型颈椎病患者术后康复与心理韧性、自我效能、自我管理均呈正相关,自我管理与心理韧性、自我效能均呈正相关,心理韧性与自我效能呈正相关(P<0.05);心理韧性和自我效能在神经根型颈椎病患者自我管理与术后康复间起中介作用,中介效应值分别为0.270、0.136,二者连续路径起链式中介效应,中介效应值为0.150,分别占总效应值的18.70%、9.42%、10.39%。结论神经根型颈椎病患者的自我管理行为对其术后康复具有重要影响,心理韧性和自我效能在其中起链式中介作用,可通过护理干预增强神经根型颈椎病患者的自我管理行为和心理韧性、提高患者的自我效能,改善其术后康复水平。Objective To analyze the mediation effect of self-efficacy and mental toughness between self-management behavior and postoperative rehabilitation in patients with cervical spondylotic radiculopathy.Methods A total of 180 patients with cervical spondylotic radiculopathy diagnosed and treated in the First Hospital of Nanchang from April 2022 to April 2024 were selected by convenience sampling method.The patients were investigated by general data questionnaire,Connor-Davidson resilience scale(CD-RISC),chronic disease self-efficacy scale(CDES),rehabilitation evaluation scale for cervical spondylotic radiculopathy(RES-CSR)and chronic disease self-management scale(CDSMS).Results The scores of CD-RISC,RES-CSR,CDES and CDSMS were(64.41±10.12)points,(78.84±12.07)points,(41.26±3.18)points and(53.14±6.38)points respectively.The results of correlation analysis showed that postoperative rehabilitation was significantly positively correlated with mental toughness,self-efficacy and self-management,self-management was significantly positively correlated with mental toughness and self-efficacy,mental toughness was significantly positively correlated with self-efficacy(P<0.05).Mental toughness and self-efficacy played a mediating role in the relationship between self-management and postoperative rehabilitation of patients with cervical spondylotic radiculopathy,and the mediating effect value was 0.270 and 0.136.The two continuous paths had a chain mediating effect,and the mediating effect value was 0.150,accounting for 18.70%,9.42%and 10.39%of the total effect value,respectively.Conclusion The self-management behavior of patients with cervical spondylotic radiculopathy has an important impact on their postoperative rehabilitation,in which mental toughness and self-efficacy play a chain intermediary role.Nursing intervention can enhance the self-management behavior and mental toughness of patients with cervical spondylotic radiculopathy and improve their self-efficacy,so as to improve their postoperative rehabilitation level.

关 键 词：自我效能 心理韧性 神经根型颈椎病 自我管理行为 术后康复 链式中介 

分 类 号：R681.5[医药卫生—骨科学]