基于压力与应对理论对肾移植受者健康相关的生活质量的研究

发布时间：2018-05-09 07:45

本文选题：肾移植受者 + 健康相关的生活质量　；参考：《北京中医药大学》2015年硕士论文

【摘要】：[目的]基于压力与应对理论,调查肾移植受者的压力、自我效能、领悟社会支持、健康认知初级评价、应对方式和健康相关的生活质量,验证假设理论模型,探讨肾移植受者的健康相关的生活质量的影响因素。[方法]在武警总医院移植随访门诊,以问卷形式调查了220名符合纳入排除标准的肾移植受者。应用健康简明量表SF-36调查肾移植受者健康相关的生活质量；应用医学应对问卷(MCMQ)调查肾移植受者的应对方式；应用领悟社会支持量表(PSSS)调查肾移植受者的社会支持水平；应用感知健康能力量表(PHCS)调查肾移植受者的自我效能水平；健康认知评价量表(CAHS)调查肾移植受者对与健康有关的潜在的压力事件的评价。采用SPSS21.0软件包对数据进行描述性分析、t检验、相关分析,采用AMOS21.0软件对假设模型进行验证性分析,确定自变量对因变量的作用路径。[结果]回收有效问卷202份,肾移植受者平均年龄为43.69±11.25岁。路径分析结果显示,在肾移植受者生理健康影响因素修正模型中,自我效能对负性评价有直接负性效应(β=-0.30),对其“屈服”应对方式有直接负性效应(β=-0.16)以及通过健康认知评价对“屈服”应对方式有间接负性效应(β=-0.13),对生理健康有直接正向效应(β=0.23)和间接正向效应(β=0.13)。领悟社会支持对其健康认知初级评价有负向直接效应(β=-0.12)；对其“屈服”应对方式有负向直接效应(β=-0.14)和负向间接效应(β=-0.05)。药物副作用症状影响对其“屈服”应对方式有正向直接效应(β=0.15)间接正向效应(β=0.10),对其“回避”应对方式有直接正向效应(β=0.27)。在肾移植受者心理健康影响因素修正模型中,自我效能对其负性评价有直接负性效应(β=-0.31),对其“屈服”应对方式有直接负性效应(β=-0.15)和间接负性效应(β=-0.14)；领悟社会支持对其健康认知初级评价有负向直接效应(β=-0.12)；对其“屈服”应对方式有负向直接效应(β=-0.14,P=0.01)和负向间接效应(β=-0.05),对其心理健康有正向直接效应(β=0.14)和正向间接效应(β=0.07)。药物副作用症状影响对其“屈服”应对方式有正向直接效应(β＝0.15)和间接正向效应(β=0.10),对其“回避”应对方式有直接正向效应(β=0.25)和间接正向效应(β=0.01)；对其心理健康有负向直接效应(β=-0.21)和负向间接效应(β=-0.11)。肾移植受者对健康压力的初级负性评价对其“屈服”应对方式有直接正向效应(β=0.45),对其生理和心理健康有负性直接效应(β=-0.32)和负性的间接效应(β=-0.15)。肾移植受者的“屈服”应对方式对其心理健康有负性直接效应(β=-0.20)。经济负担(β=0.15)、肌酐指标(β=0.15)以及药物副作用症状影响对其健康认知的初级负性评价有直接正向效应(β=0.22)。,对心理健康有负向直接效应(β=-0.21)。研究中纳入的外因变量可以解释肾移植受者生理和心理健康30%和38%的变异量。[结论]在本研究中,通过对假设模型的验证,“经济负担”“、”“生化指标-肌酐”“和“药物副作用症状影响”会被肾移植受者评价为压力,压力越大,越倾向于负性评价,进而影响受者采取何种方式应对压力；“屈服”应对方式会直接有损于受者的心理健康。肾移植受者健康相关的生活质量受到很多复杂因素的影响,各个因素通过不同的路径最终影响受者的生活质量,在今后对肾移植受者健康相关的生活质量研究中,进一步对影响因素进行分组,深入探讨影响因素对受者生活质量影响的机制。
[Abstract]:[Objective] to investigate the pressure, self efficacy, understanding of social support, primary evaluation of health cognition, coping style and health related quality of life based on pressure and coping theory, and to verify the hypothesis model and explore the factors affecting the health related quality of life in renal transplant recipients. [Methods] transplant follow-up in general hospital of armed police. A questionnaire was used to investigate 220 renal transplant recipients who met the exclusion criteria. A health concise scale SF-36 was used to investigate the health related quality of life related to renal transplant recipients; the Medical Coping Questionnaire (MCMQ) was used to investigate the coping styles of renal transplant recipients; and the social support scale (PSSS) was used to investigate the social support of renal transplant recipients. Holding the level; using the perceived health ability scale (PHCS) to investigate the self-efficacy level of renal transplant recipients; the health cognition Assessment Scale (CAHS) was used to investigate the evaluation of the potential stress events related to the health of kidney transplant recipients. The data were analyzed by the SPSS21.0 software package, the t test, the correlation analysis, and the AMOS21.0 software. A model was set up to verify the effect of the independent variable on the dependent variable. [results] 202 valid questionnaires were recovered and the average age of renal transplant recipients was 43.69 + 11.25 years. The results of path analysis showed that the self efficacy had a direct negative effect on negative evaluation in the model of the factors affecting the physiological health factors of the recipients of renal transplantation (beta =-0.30), Its "yield" coping style had direct negative effect (beta =-0.16) and indirect negative effect (beta =-0.13) on "yield" coping style through health cognition assessment (beta =-0.13), and direct positive effect (beta =0.23) and indirect positive effect (beta =0.13) on physiological health. 12); there were negative direct effect (beta =-0.14) and negative indirect effect (beta =-0.05) on its "yield" coping style. The effect of drug side effects on its "yield" coping style had a positive direct effect (beta =0.15), and the "avoidance" should have a direct positive effect on the way of "avoiding" (beta =0.27). In the health impact factor correction model, self efficacy has a direct negative effect on its negative evaluation (beta =-0.31), which has a direct negative effect (beta =-0.15) and indirect negative effect (beta =-0.14) on the "yield" coping style, and the perceived social support has a negative direct effect on its primary evaluation of health cognition (beta =-0.12), and its "yield" response to it. The negative direct effect (beta =-0.14, P=0.01) and negative indirect effect (beta =-0.05) have positive direct effect (beta =0.14) and positive indirect effect (beta =0.07) on their mental health. The effect of side effects on the "yield" coping style has positive direct effect (beta = 0.15) and indirect positive effect (beta =0.10) on its "avoidance" response. There were direct positive effects (beta =0.25) and indirect positive effect (beta =0.01), negative direct effect (beta =-0.21) and negative indirect effect (beta =-0.11) on their mental health. The primary negative evaluation of renal transplant recipients had direct positive effect on their "yield" coping style (beta =0.45), and negative to their physiological and psychological health. Direct effect (beta =-0.32) and negative indirect effect (beta =-0.15). The "yield" coping style of renal transplant recipients has a negative direct effect on their mental health (beta =-0.20). The economic burden (beta =0.15), creatinine index (beta =0.15) and drug side effects have a direct positive effect on the primary negative evaluation of their health cognition (beta =0.22). Psychological health has a negative direct effect (beta =-0.21). The exogenous variables included in the study can explain the variation in physiological and psychological health of 30% and 38% in renal transplant recipients. [Conclusion] in this study, the "economic burden" "," "biochemical indicators muscle anhydride" and "the effect of the side effects of drug" in this study will be treated by the kidney. The greater the stress, the greater the stress, the more the stress, the more negative evaluation, and then the way the recipient takes the stress. The "yield" coping style will directly damage the psychological health of the recipient. The health related quality of life of the recipients of the renal transplant recipients is influenced by many complex factors, and the factors are finally influenced by different paths. The quality of life of the recipients, in the future study of the health related quality of life of the recipients of renal transplantation, further study the influencing factors and explore the mechanism of influence factors on the quality of life of the recipients.

【学位授予单位】：北京中医药大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R473.6

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