住院病人心理应激反应及其影响因素的模型构建

发布时间：2018-04-25 04:31

本文选题：住院病人 + 心理应激反应　；参考：《中南大学》2007年硕士论文

【摘要】： 目的：检验医院应激量表中文版的信效度，，在此基础上，对住院患者的应激源、中介机制、心理应激反应进行一个全面而整体的研究，建立一个住院病人心理应激反应及其影响因素的结构方程模型，明确影响住院患者心理状况的主要因素之间的相互关系，从整体角度探明这些因素对心理反应的作用方式和贡献大小。方法：本研究为横断面调查研究。采取分层--随机--整群抽样方法，抽取2006年9月到2007年3月在长沙市八所省级和市级医院住院的非精神科住院病人754例，使用相应量表调查住院病人的应激源、应对方式、自我效能、社会支持、人格和住院的心理反应。使用SPSS 13．0对所有资料进行统计描述、方差分析、相关分析、多元线性回归分析，使用LISREL8．70对各量表进行验证性因素分析，并在以上统计分析基础上进行结构方程的建构、修正和评价。结果：1．大部分量表的cronbach's alpha系数大于0.6，条目间平均相关系数(MIC)在0.10-0.50之间，尤其是住院病人心理评定量表的信度比较好；医院应激评定量表α系数为0.843，MIC为0.102，分量表的α系数为0.47～0.73，各分量表条目MIC在0.1～0.2之间，总量表及各维度的重测信度均在0.60以上。各量表效度也达到测量学要求(CFI，IFI，GFI均大于0.90，RMSEA＜0.10)。2．进入构建结构方程模型的中介变量为：医院应激、支持、病程、经济、自我效能、神经质、内外向、回避。3．结构方程模型拟合较好：X~2／df＜3，CFI，IFI，GFI均大于0.90，RMSEA＜0.05。结论：1．本研究构建出一个住院病人的心理应激模型，具有较好的拟合指数。2．该模型显示自我效能是一个重要的中介变量，应对方式“屈服”对心理状况的影响也很大；医院应激除了直接作用于心理状况，还通过回避、屈服、神经质对心理状况起间接作用；回避、屈服、神经质、内外向、社会支持除了直接作用于心理状况，还部分通过自我效能对心理状况产生影响；病程和经济地位对病人的心理状况有直接的影响，同时经济地位也可以影响社会支持。3．医院应激评定量表的信度和效度基本达到要求，可以在调查中使用。
[Abstract]:Objective: to test the reliability and validity of the Chinese version of the Hospital stress scale, and to conduct a comprehensive and holistic study on the stressors, mediators and psychological stress responses of the inpatients on the basis of the reliability and validity of the Chinese version of the scale. To establish a structural equation model of psychological stress response and its influencing factors of inpatients, and to clarify the relationship between the main factors that affect the psychological status of hospitalized patients. From the overall point of view, the effects of these factors on psychological response and contribution. Methods: this study is a cross-sectional investigation. From September 2006 to March 2007, 754 non-psychiatric inpatients in eight provincial and municipal hospitals in Changsha were selected by stratified random-cluster sampling. The stressors and coping styles of inpatients were investigated with the corresponding scale. Self-efficacy, social support, personality, and psychological response to hospitalization. SPSS 13.0 was used to describe all the data, ANOVA, correlation analysis, multivariate linear regression analysis, LISREL8.70 to verify the factors of each scale, and on the basis of the above statistical analysis to construct the structural equation. Revision and evaluation The result is 1: 1. The cronbach's alpha coefficient of most scales was greater than 0.6, and the average correlation coefficient between items was between 0.10-0.50, especially the reliability of psychological rating scale for inpatients was better. The 伪 coefficient of hospital stress rating scale was 0.843 and 0.102, and the 伪 coefficient of component scale was 0.470.73. The MIC of each subscale item was between 0.1 and 0.2, and the test-retest reliability of the total scale and each dimension was more than 0.60. The validity of each scale also met the requirement of measurement. The GFI of CFI and IFI was higher than 0.90 RMSEA < 0.10g 路2. The intermediate variables involved in structure-equation model are: hospital stress, support, course of disease, economy, self-efficacy, neuroticism, introversion and extroversion. The structure equation model fits well with the structure equation model. The structure equation model is more than 0.90% RMSEA < 0.05, and the CFI GFI is less than 3%. Conclusion 1. In this study, a psychological stress model of inpatients was constructed, with a good fitting index. 2. 2. The model shows that self-efficacy is an important intermediary variable, and the coping style "surrender" has a great influence on psychological condition. Neuroticism plays an indirect role in mental state, avoidance, submission, neuroticism, introversion, social support not only act directly on mental state, but also influence mental state partly through self-efficacy. Course of disease and economic status have a direct impact on the psychological status of patients, and economic status can also affect social support. 3. The reliability and validity of the hospital stress rating scale can be used in the investigation.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2007
【分类号】：R395

【引证文献】