脑卒中患者家属照顾者心理弹性、社会支持与应对方式的相关性研究

发布时间：2018-04-29 21:39

本文选题：脑卒中 + 家属照顾者　；参考：《北京中医药大学》2017年硕士论文

【摘要】：目的:描述脑卒中患者家属照顾者心理弹性、社会支持及应对方式状况;探讨脑卒中患者家属照顾者心理弹性的影响因素;分析脑卒中患者家属照顾者心理弹性与社会支持和应对方式的相关关系;探索脑卒中患者家属照顾者的心理弹性在其社会支持与应对方式之间的中介效应,为促进家属照顾者对疾病及照顾工作采取积极的应对方式,提供依据和指导。方法:本研究采用横断面调查方法,于2016年4月～2016年12月便利抽取北京市三所三级甲等医院神经内科病房脑卒中患者及其家属照顾者各236名。研究工具包括一般资料调查问卷、巴氏指数评定量表(Barthelindex,BI)、心理弹性量表(Connor-Davidson Resilience Scale,CD-RISC)、简易应对方式量表(Simplified Coping Style Questionnaire,SCSQ)和社会支持评定量表(Social Support Rating Scale,SSRS)。使用Excel软件对数据进行录入,利用SPSS 22.0统计软件进行数据分析,统计方法包括描述性分析、t检验、方差分析、线性相关分析、多元线性逐步回归分析等。结果:1.脑卒中患者家属照顾者心理弹性平均得分为(69.46± 12.29)分;应对方式方面,积极应对的中位数和四分位数间距为25.00(8.00),消极应对的中位数和四分位数间距是8.00(7.00);社会支持平均得分为(37.96±8.19)分。2.多元线性逐步回归分析结果显示,脑卒中患者家属照顾者性别、文化程度、工作状况、每天照顾时间、照顾压力和积极应对均进入多元线性回归方程模型,能解释39.80%的变异。3.相关分析结果显示,脑卒中患者家属照顾者心理弹性与积极应对呈正相关(P0.01),与消极应对呈负相关(P0.01);社会支持与心理弹性呈正相关(P0.05);社会支持与积极应对呈正相关(P0.05),与消极应对呈负相关(P0.05)。4.中介效应分析结果显示,脑卒中患者家属照顾者的社会支持对其积极应对方式的影响是通过心理弹性者的中介效应,中介效应占总效应的40.21%;社会支持对其消极应对方式的影响是通过心理弹性者的中介效应,中介效应占总效应的16.73%。结论:1.脑卒中患者家属照顾者心理弹性呈中等水平,表明照顾者对逆境有一定的反弹能力;积极应对水平处于中等,消极应对水平偏低;社会支持总体处于中上等水平,说明照顾者的社会支持水平较好。2.脑卒中患者家属照顾者心理弹性的影响因素包括性别、文化程度、工作状况、每天照顾时间、照顾压力和积极应对。3.脑卒中患者家属照顾者心理弹性、社会支持及心理弹性具有相关性,即心理弹性水平和社会支持水平高的家属照顾者,越倾向采取积极应对方式;照顾者的社会支持度越高,其心理弹性越高。4.脑卒中患者家属照顾者的社会支持通过心理弹性的中介效应对,从而影响其应对方式,表明护理工作者可通过提高家属照顾者的社会支持水平,增强其心理弹性,从而间接引导照顾者采取积极的认知和行为策略。
[Abstract]:Objective: to describe the psychological elasticity, social support and coping style of family caregivers of stroke patients, and to explore the influencing factors of family caregivers' mental resilience. The relationship between family caregivers' psychological elasticity and social support and coping style was analyzed, and the mediating effect of family caregivers' psychological elasticity between social support and coping style was explored. In order to promote the family caregivers to take a positive response to disease and care, provide the basis and guidance. Methods: from April 2016 to December 2016, 236 stroke patients and their relatives in neurology wards of three Grade 3A hospitals in Beijing were selected by cross-sectional investigation. The research tools included general data questionnaire, Barthel Index scale, Connor-Davidson Resilience scale, simplified Coping Style questionnaire and Social support scale. The Excel software is used to input the data and the SPSS 22.0 statistical software is used to analyze the data. The statistical methods include descriptive analysis t test, variance analysis, linear correlation analysis, multivariate linear stepwise regression analysis and so on. The result is 1: 1. The average score of psychological elasticity was 69.46 卤12.29, the median and quartile spacing of positive coping was 25.00 卤8.00, the median and quartile spacing of negative coping was 8.00 卤7.00, and the average score of social support was 37.96 卤8.19). The results of multiple linear stepwise regression analysis showed that the gender, education level, working condition, care time, care stress and positive coping of relatives of stroke patients were all involved in the multiple linear regression equation model, which could explain 39.80% of the variation. 3. The results of correlation analysis show that There was a positive correlation between psychological elasticity and positive coping in family caregivers of stroke patients, a negative correlation between social support and negative coping, a positive correlation between social support and mental resilience, a positive correlation between social support and positive coping, and a negative correlation between social support and negative coping. The results of intermediary effect analysis showed that the influence of social support of family caregivers on the positive coping style of stroke patients was mediated by the psychological flexibility. The mediating effect accounts for 40.21% of the total effect, and the influence of social support on its negative coping style is through the intermediary effect of the person with psychological elasticity, and the intermediary effect accounts for 16.73% of the total effect. Conclusion 1. The psychological elasticity of caregivers of stroke patients' family members showed a moderate level, indicating that caregivers had a certain ability to rebound against adversity; positive coping level was medium, negative coping level was low; social support was generally at the middle and upper level. The social support level of caretaker is better. 2. 2. The factors influencing the mental resilience of family caregivers of stroke patients included gender, education level, work status, care time per day, care stress and positive coping. 3. The family caregivers of stroke patients were more likely to adopt the positive coping style, and the social support and the psychological elasticity were correlated, that is, the family caregivers with high level of psychological elasticity and social support were more likely to adopt the positive coping style, and the social support of the caregivers was higher. Their psychological resilience is higher. 4. The social support of caregivers of family members of stroke patients affected their coping style through the intermediary effect of psychological elasticity, which indicated that nursing workers could enhance their psychological resilience by improving the level of social support of family caregivers. Thus indirectly guide caregivers to adopt positive cognitive and behavioral strategies.
【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】：2017
【分类号】：R473.74

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