哮喘患者睡眠质量与心理控制源、心理弹性的关系：情绪困扰的中介作用

发布时间：2018-06-07 21:18

本文选题：哮喘患者 + 睡眠质量　；参考：《山东大学》2017年硕士论文

【摘要】：目的了解哮喘患者的睡眠质量现状,分析情绪困扰、心理控制源、心理弹性与睡眠质量的相关性,并探讨情绪困扰在心理控制源与睡眠质量之间、心理弹性与睡眠质量之间可能存在的中介机制,能够给寻找提升睡眠质量的心理干预方法提供新的途径与思路。方法采用方便抽样的方法,于2015年10月至2016年10月在山东省某三级甲等医院的呼吸科门诊募集研究被试者195名。采用问卷调查,自编的人口学和疾病信息调查表,PSQI睡眠质量问卷,Kessler情绪困扰量表,以及内控性、机遇和有势力他人量表和CD-RISC 10心理弹性量表等,评估被试者的睡眠质量、心理控制源、心理弹性和情绪状态。采用SPSS 22.0软件进行统计分析,包括t检验、单因素方差分析、Pearson相关及分层回归进行统计分析,并采用偏差校正的Bootstrap法进行中介效应显著性检验。结果1.195例哮喘患者的人口学、疾病信息情况195例哮喘患者的年龄在18～78岁之间,平均(50.22±14.71)岁。其中,男性约50.3%,92.7%已婚,大专及以上学历者占40%,来自农村或乡镇者占53.3%,家庭经济中等以上者占94.9%,BMI指数正常者占64.6%,40.5%被诊断为典型呼吸困难型哮喘,有5年以上发病史者占42.1%,74.4%的患者哮喘发作次数超过1次,有家族史者为13.8%,31.3%存在并发症者,肺功能中重度者占31.3%。2.哮喘患者睡眠质量PSQI得分及差异分析195例哮喘患者的睡眠质量PSQI得分为7.54±3.25,其中,60.7%的患者存在睡眠障碍(即PSQI总分≥5分)。单因素方差分析和t检验的结果表明,PSQI得分在年龄、文化程度、疾病诊断、病史、发作次数、有无并发症等变量存在差异,表现为高龄、文化程度低、疾病诊断严重、病史长、发作次数多、有并发症的哮喘患者的PSQI得分高于其他分组(P0.05)。3.相关性分析Pearson相关分析表明,睡眠质量PSQI得分与心理控制源中的机遇(r=0.298,P0.001)和有势力他人(r=0.202,P0.001)呈正相关,与心理弹性(r=-0.245,P0.01)呈负相关,与情绪困扰(r=0.277,P0.001)呈正相关,同时心理控制源、心理弹性及情绪困扰两两之间的相关性也达到显著性水平。4.单因素回归分析以哮喘患者睡眠质量PSQI总分为因变量,分别以心理控制源、心理弹性和情绪困扰为自变量,进行单因素回归分析,三个单因素回归方程的结果表明,心理控制源中机遇维度(β=0.320,P=0.002)、心理弹性(β=0.245,P=0.001)和情绪困扰(β=0.277,P0.001)分别对睡眠质量有预测作用。5.分层回归分析和中介效应检验控制人口学和疾病信息资料后,以PSQI总分为因变量,情绪困扰为中介变量,机遇和心理弹性分别为自变量进行分层回归分析,结果表明情绪困扰在机遇与睡眠质量、心理弹性与睡眠质量之间有中介作用,中介效应值分别为18.81%、46.19%。采用Hayes提出的偏差校正的Bootstrap法进一步检验情绪困扰在机遇与睡眠质量、心理弹性与睡眠质量之间的中介作用,两个中介模型的效应置信区间均不跨零,表明中介模型成立。结论1.哮喘患者睡眠质量较差,约三分之二存在睡眠问题;2.情绪困扰、心理控制源、心理弹性均可预测哮喘患者的睡眠质量;3.情绪困扰在心理控制源与睡眠质量之间、心理弹性与睡眠质量之间起到中介作用。
[Abstract]:Objective to understand the status of sleep quality in asthmatic patients, to analyze the correlation between emotional disturbance, psychological control source, mental resilience and sleep quality, and to explore the possible intermediation mechanism between psychological control and sleep quality, psychological resilience and sleep quality, which can provide psychological intervention for improving sleep quality. Methods to provide new ways and ideas. Methods using a convenient sampling method, 195 subjects were collected from the Department of respiration of a class three grade a hospital of Shandong province from October 2015 to October 2016. The questionnaire survey, the self compiled demographic and disease information questionnaire, the PSQI sleep quality questionnaire, the Kessler emotional distress scale, and the internal control were used. Opportunities and powerful others scale and CD-RISC 10 Mental Resilience Scale were used to evaluate the quality of sleep, locus of control, mental resilience and emotional state of the subjects. Statistical analysis was carried out by SPSS 22 software, including t test, single factor analysis of variance, Pearson correlation and stratified return, and the Bootstrap method of deviation correction was used. Results 1.195 cases of asthma patients' demography, 195 cases of asthma patients aged 18~78 years old, the average age of 18~78 years old (50.22 + 14.71) years old. Among them, the male was 50.3%, 92.7% married, junior college and above, 40%, 53.3% from rural or township, 94.9%, and 94.9%, BMI Those with normal index accounted for 64.6%, 40.5% were diagnosed as typical dyspnea asthma, 42.1% had a history of more than 5 years, 74.4% had more than 1 episodes of asthma, 13.8% had a family history, 31.3% had complications, and moderate to severe pulmonary function accounted for the sleep sleep quality PSQI scores and difference analysis of the 31.3%.2. asthmatic patients, 195 cases of asthmatic patients' sleep The score of sleep quality PSQI was 7.54 + 3.25, of which 60.7% of the patients had sleep disorders (i.e., PSQI total score or more than 5). The results of single factor variance analysis and t test showed that the PSQI scores were in age, education, disease diagnosis, disease history, attack times, and complications, such as age, low education, disease diagnosis, disease. The PSQI score of the patients with complications was higher than that of other groups (P0.05).3. correlation analysis Pearson correlation analysis showed that the sleep quality PSQI score was positively related to the opportunity (r=0.298, P0.001) in the locus of control (r=0.298, P0.001) and the powerful others (r=0.202, P0.001), and was negatively correlated with the psychological elasticity (r=-0.245, P0.01). The r=0.277 (P0.001) was positively correlated, while the correlation between psychological control sources, mental resilience and emotional distress 22 was also reached a significant level of.4. single factor regression analysis. The total score of sleep quality PSQI in asthmatic patients was the dependent variable, and the psychological control source, mental resilience and emotional distress were independent variables, and the single factor regression analysis was carried out. Analysis, the results of three single factor regression equations show that the opportunity dimension (beta =0.320, P=0.002), psychological elasticity (beta =0.245, P=0.001) and emotional distress (beta =0.277, P0.001) have predictive effect on the quality of sleep, respectively,.5. stratified regression analysis and intermediary effect test control demographic and disease information, with the total score of PSQI as the cause of change. Quantity, emotional distress as mediating variables, opportunity and mental resilience are stratified regression analysis of independent variables. The results show that emotional distress has a mediating effect between opportunity and sleep quality, mental resilience and sleep quality, and the median effect value is 18.81% respectively, and 46.19%. uses the Bootstrap method of deviation correction proposed by Hayes to further examine the situation. The intermediate role of the mood between opportunity and sleep quality, mental resilience and sleep quality, the confidence intervals of the two mediating models are not zero, indicating the establishment of intermediate model. Conclusion 1. the sleep quality of asthmatic patients is poor, about 2/3 have sleep problems, 2. emotional disturbances, psychological control sources, and mental resilience can predict asthma patients. 3., emotional distress played an intermediary role between the locus of control and sleep quality, and the relationship between resilience and sleep quality.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.5

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