康复自我效能在青中年脑卒中患者病耻感与创伤后成长间的中介效应分析  

Analysis of the Mediating Effect of Stroke Self-Efficacy on Stigma and Posttraumatic Growth in Young and Middle-Aged Stroke Patients

作　　者：胡荣利 汪莉[3] 庞舒娴 韦月琴 韦佩伶 李建民[3] HU Rongli;WANG Li;PANG Shuxian;WEI Yueqin;WEI Peiling;LI Jianmin(Faculty of Nursing,Guangxi University of Chinese Medicine,Nanning 530000,China;Department of Neurosurgery,Liuzhou Worker's Hospital,Liuzhou 545000,China;Department of Nursing,the Second Nanning People's Hospital,Nanning 530000,China)

机构地区：[1]广西中医药大学护理学院,广西壮族自治区南宁市530000 [2]广西壮族自治区柳州市工人医院神经外科,545000 [3]广西壮族自治区南宁市第二人民医院护理部,530000

出　　处：《实用心脑肺血管病杂志》2025年第4期127-131,共5页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：广西科技计划项目(桂科AA22096032,桂科AB18221006)。

摘　　要：目的 探讨康复自我效能在青中年脑卒中患者病耻感与创伤后成长间的中介效应。方法 选取2024年1—6月在柳州市工人医院神经内科、神经外科住院的青中年脑卒中患者210例为调查对象,采用一般资料调查表、脑卒中患者病耻感量表(SSS)、中文版脑卒中康复自我效能量表(SSEQ)、创伤后成长评定量表(PTGI)对其进行调查。两变量间的相关性分析采用Spearman秩相关分析;采用Harman单因素法进行共同方法偏差检验,采用SPSS Process插件中的Model 4模块构建中介效应模型,重复抽样5 000次,采用Bootstrap法进行中介效应检验。结果 本研究共发放问卷210份,回收有效问卷202份,有效回收率为96.2%。202例青中年脑卒中患者SSS评分47.0(43.0,58.0)分,中文版SSEQ评分57.0(39.0,66.0)分,PTGI评分45.0(38.0,54.0)分。Spearman秩相关分析结果显示,青中年脑卒中患者SSS评分与中文版SSEQ评分、PTGI评分均呈负相关(P<0.05),中文版SSEQ评分与PTGI评分呈正相关(P<0.05)。共同方法偏差检验结果显示,在提取出的8个特征值>1的公因子中,第1个公因子对总变量的解释率小于临界值40%,为38.46%,表明不存在严重的共同方法偏差。以SSS评分为自变量,中文版SSEQ评分为中介变量,PTGI评分为因变量,构建中介效应模型,中介效应检验结果显示,总效应值为-0.629 8[95%CI(-0.751 9~-0.597 8)],直接效应值为-0.399 4[95%CI(-0.544 8~-0.253 9)],间接效应值为-0.230 5[95%CI(-0.322 4~-0.135 7)],该中介效应模型间接效应显著,SSS评分对青中年脑卒中患者PTGI评分具有负向预测作用(β=-0.399 4,P<0.001),中文版SSEQ评分在青中年脑卒中患者SSS评分和PTGI评分间起部分中介作用(β=0.222 3,P<0.001),占总效应的36.6%。结论 病耻感对青中年脑卒中患者创伤后成长具有负向预测作用,且康复自我效能在青中年脑卒中患者病耻感与创伤后成长间起部分中介作用。Objective To investigate the mediating effect of stroke self-efficacy on stigma and posttraumatic growth in young and middle-aged stroke patients.Methods A total of 210 young and middle-aged stroke patients hospitalized in the Department of Neurology and Neurosurgery of Liuzhou Worker's Hospital from January to June 2024 were selected as the investigation objects.The General Data Questionnaire,the Stroke Stigma Scale(SSS),the Chinese version of Stroke Self-efficacy Questionnaire(SSEQ)and Posttraumatic Growth Inventory(PTGI)were used to investigate the patients.Spearman rank correlation analysis was used to analyze the correlation between the two variables.The Harman single factor method was used for common method deviation test.The Model 4 module of the SPSS Process plug-in was used to build the mediation effect model,repeated sampling was performed 5000 times,and the Bootstrap method was used to test the mediating effects.Results A total of 210 questionnaires were sent out in this study,and 202 were effectively collected,with an effective recovery rate of 96.2%.Two hundred and two young and middle-aged stroke patients had SSS scores of 47.0(43.0,58.0),Chinese version of SSEQ scores of 57.0(39.0,66.0)and PTGI scores of 45.0(38.0,54.0).Spearman rank correlation analysis showed that in young and middleaged stroke patients,SSS scores were negatively correlated with Chinese version of SSEQ scores and PTGI scores(P<0.05),while Chinese version of SSEQ scores were positively correlated with PTGI scores(P<0.05).The common method bias test results showed that among the extracted 8 common factors with eigenvalue>1,the explanation rate of the first common factor to the total variable was less than the critical value of 40%,which was 38.46%,indicating that there was no serious common method bias.With SSS score as the independent variable,Chinese version of SSEQ score as the mediating variable,and PTGI score as the dependent variable,a mediating effect model was constructed.The results of the mediating effect test showed that

关 键 词：卒中 青年人 中年人 康复 自我效能 病耻感 创伤后成长 心理 中介效应 

分 类 号：R743[医药卫生—神经病学与精神病学]