社会支持对结直肠癌造口患者自我效能的影响路径分析
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摘要
目的探索社会支持对结直肠癌造口患者自我效能的影响路径。方法采用社会支持评定量表、心理韧性量表、造口患者自我效能感量表对242例结直肠癌造口患者进行调查。使用极大似然法及非参数百分位Bootstrap法检验心理韧性的中介效应。结果自我效能与心理韧性呈正相关(r=0.446,P<0.001)和社会支持呈正相关(r=0.241,P<0.001);社会支持与心理韧性呈正相关(r=0.329,P<0.001);社会支持不仅可以直接影响结直肠癌造口患者的自我效能水平,还可以通过心理韧性这一中介作用间接影响其自我效能水平,中介效应占总效应的55.4%。结论心理韧性在结直肠癌造口患者社会支持对自我效能的影响中起部分中介作用。
Objective To examine the correlations of self-efficacy and social support of patients with colorectal cancer patients after colostomy,and to identify the mediating effects of psychological resilience. Methods A total of 242 permanent stoma patients questionnaire survey was conducted with the stoma patients. Structural equation models and the Bootstrap method were used to analyze the mediating effect of psychological resilience. Results The Stoma Self-Efficacy was positively correlated with resilience and social support(r=0.446 and r=0.241,P<0.001).Social support was positively associated with resilience(r=0.329,P<0.001). Social support can not only directly affect the self-efficacy level of patients with,but also indirectly affect the level of self-efficacy through the mediating effect of psychological resilience. The mediating effect accounted for 55.4% of the total effect. Conclusion The psychological resilience had partial mediation effect between social support and stoma self-efficacy.
Objective To examine the correlations of self-efficacy and social support of patients with colorectal cancer patients after colostomy,and to identify the mediating effects of psychological resilience. Methods A total of 242 permanent stoma patients questionnaire survey was conducted with the stoma patients. Structural equation models and the Bootstrap method were used to analyze the mediating effect of psychological resilience. Results The Stoma Self-Efficacy was positively correlated with resilience and social support(r=0.446 and r=0.241,P<0.001).Social support was positively associated with resilience(r=0.329,P<0.001). Social support can not only directly affect the self-efficacy level of patients with,but also indirectly affect the level of self-efficacy through the mediating effect of psychological resilience. The mediating effect accounted for 55.4% of the total effect. Conclusion The psychological resilience had partial mediation effect between social support and stoma self-efficacy.
引文
[1]张铁玲,胡爱玲,徐洪莲,等.结肠造口患者残障接受度与社会关系质量的相关性研究[J].中华护理杂志,2013,48(3):241-244.
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[14]王惠珍,秦芳,苏茜,等.不同类型肠造口者生存质量和自我效能的关系分析[J].实用医学杂志,2015,31(12):2049-2052.
[15]Tao H,Songwathana P,Isaramalai SA,et al.Personal awareness and behavioural choices on having a stoma:a qualitative meta synthesis[J].Journal of Clinical Nursing,2014,23(9-10):1186-1200.
[16]Bell C,Asolati M,Hamilton E,et al.A comparison of complications associated with colostomy reversal versus ileostomy reversal[J].Am J Surg,2005,190(5):717-720.
[17]曹蕾,杨帆,莫洁玲.护理高职生心理弹性在社会支持与心理健康间的中介作用[J].中华护理教育,2017,14(6):462-466.
[18]Taylor H,Reyes H.Self-efficacy and resilience in baccalaureate nursing students[J].Int J Nurs Educ Scholarsh,2012,9(1):1-13.
[19]Wang L,Tao H,Bowers BJ,et al.Influence of social support and self-efficacy on resilience of early career registered nurses[J].West J Nurs Res,2018,40(5):648-664.
[20]谢玲平,王洪礼,邹维兴,等.留守初中生自我效能感与社会适应的关系:心理韧性的中介作用[J].中国特殊教育,2014(7):52-58.
[21]王安妮,张静平.高三学生心理弹性影响因素:社会支持与学业自我效能感[J].中国健康心理学杂志,2015,23(12):1840-1843.
[22]孙静,李伟.心理韧性在社区老年人抑郁与社会支持关系间的中介效应研究[J].中国全科医学,2015,18(7):827-830.
[2]王振军.直肠癌柱状经腹会阴切除术[J].中华结直肠疾病电子杂志,2012,1(2):5-8.
[3]Krouse RS,Grant M,McCorkle R,et al.A chronic care ostomy self-management program for cancer survivors[J].Psycho-Oncology,2016,25(5):574-581.
[4]Bandura A.Self-efficacy:toward a unifying theory of behavioral change[J].Advances in Behaviour Research and Therapy,1977,1(4):139-161.
[5]董筱倩.结直肠癌幸存者支持性照顾需求与造口自我效能的相关性研究[J].护理研究,2016,30(3B):3060-3063.
[6]Connor KM,Davidson JR.Development of a new resilience scale:The Connor-Davidson Resilience Scale(CD-RISC)[J].Depression and Anxiety,2003,18(2):76-82.
[7]钟杏.胃肠癌患者心理韧性、一般自我效能感、应对方式及生活质量的相关研究[D].南昌:南昌大学,2013.
[8]Friborg O,Hjemdal O,Rosenvinge JH,et al.A new rating scale for adult resilience:what are the central protective resources behind healthy adjustment?[J].Int J Methods Psychiatr Res,2003,12(2):65-76.
[9]肖水源.《社会支持评定量表》的理论基础与研究应用[J].临床精神医学杂志,1994,4(2):98-100.
[10]Yu XN,Zhang JX.Factor analysis and psychometric evaluation of the Connor-Davidson Resilience Scale(CD-RISC)with Chinese people[J].Soc Behav Pers,2007,35(1):19-30.
[11]Bekkers MJ,Van Knippenberg FC,Van Den Borne HW,et al.Prospective evaluation of psychosocial adaptation to stoma surgery:the role of self-efficacy[J].Psychosom Med,1996,58(2):183-191.
[12]Wu HK,Chau JP,Twinn S.Self-efficacy and quality of life among stoma patients in Hong Kong[J].Cancer Nurs,2007,30(3):186-193.
[13]温忠麟,叶宝娟.中介效应分析:方法和模型发展[J].心理科学进展,2014,22(5):731-745.
[14]王惠珍,秦芳,苏茜,等.不同类型肠造口者生存质量和自我效能的关系分析[J].实用医学杂志,2015,31(12):2049-2052.
[15]Tao H,Songwathana P,Isaramalai SA,et al.Personal awareness and behavioural choices on having a stoma:a qualitative meta synthesis[J].Journal of Clinical Nursing,2014,23(9-10):1186-1200.
[16]Bell C,Asolati M,Hamilton E,et al.A comparison of complications associated with colostomy reversal versus ileostomy reversal[J].Am J Surg,2005,190(5):717-720.
[17]曹蕾,杨帆,莫洁玲.护理高职生心理弹性在社会支持与心理健康间的中介作用[J].中华护理教育,2017,14(6):462-466.
[18]Taylor H,Reyes H.Self-efficacy and resilience in baccalaureate nursing students[J].Int J Nurs Educ Scholarsh,2012,9(1):1-13.
[19]Wang L,Tao H,Bowers BJ,et al.Influence of social support and self-efficacy on resilience of early career registered nurses[J].West J Nurs Res,2018,40(5):648-664.
[20]谢玲平,王洪礼,邹维兴,等.留守初中生自我效能感与社会适应的关系:心理韧性的中介作用[J].中国特殊教育,2014(7):52-58.
[21]王安妮,张静平.高三学生心理弹性影响因素:社会支持与学业自我效能感[J].中国健康心理学杂志,2015,23(12):1840-1843.
[22]孙静,李伟.心理韧性在社区老年人抑郁与社会支持关系间的中介效应研究[J].中国全科医学,2015,18(7):827-830.