领悟社会支持在肺动脉高压患...与心理弹性间的中介作用分析_袁夏霖.pdf

现代医学Modern Medical Journal2023，Apr;51(4):494-5002018，63(3):610-618 28MCLACHLAN S A，CLEMENTS A，AUSTOKE J Patientsexperiences and reported barriers to colonoscopy in the screen-ing context-a systematic review of the literature J PatientEduc Couns，2012，86(2):137-146 29 ENGWALL M，DUPPILS G S Music as a nursing interventionfor postoperative pain:a systematic reviewJ J PerianesthNurs，2009，24(6):370-383 30 NILSSON U The anxiety and pain-reducing effects of musicinterventions:a systematic reviewJ Aorn J，2008，87(4):780-807 31 WANG M C，ZHANG L Y，ZHANG Y L，et al Effect of musicin endoscopy procedures:systematic review and meta-analysisof randomized controlled trials J Pain Med，2014，15(10):1786-1794 32 程梅 音乐治疗疾病的探讨J 中国中西医结合杂志，1998(9):565-566 33 TAM W W，WONG E L，TWINN S F Effect of music on pro-cedure time and sedation during colonoscopy:a meta-analysis J World J Gastroenterol，2008，14(34):5336-5343 34 沈迁，刘雪梅，胡海荣，等 背景音乐联合心理干预对结肠镜检查患者应激反应的影响J 宁夏医学杂志，2018，40(6):563-564 35 HSU C C，CHEN S，LEE P H，et al The effect of music lis-tening on pain，heart rate variability，and range of motion in ol-der adults after total knee replacementJ Clin Nurs es，2019，28(5):529-547 36 KAVAKLI A S，KAVUT O N，YAVUZEL A H，et al Theeffects of music on anxiety and pain in patients during carotidendarterectomy under regional anesthesia:A randomized con-trolled trial J Complement Ther Med，2019，44:94-101 37 耿婕，李奇男，王莉薇，等 音乐疗法在消化内镜检查过程中干预效果的 Meta 分析J 重庆医学，2017，46(16):2233-2237 收稿日期2023-01-26 修回日期2023-03-29 基金项目南京市卫生科技发展基金项目(YKK22101);南京医科大学科技发展基金项目(NMUB2018326)作者简介袁夏霖(1981 )，女，江苏南京人，主管护师。E-mail:yuanrx7844126 com 通信作者乔积民E-mail:qiaojve1986163 com 引文格式袁夏霖，乔积民，周小平，等 领悟社会支持在肺动脉高压患者主观幸福感与心理弹性间的中介作用分析J 现代医学，2023，51(4):494-500 论著 领悟社会支持在肺动脉高压患者主观幸福感与心理弹性间的中介作用分析袁夏霖，乔积民，周小平，黄天熠，吴志明 南京医科大学附属南京医院(南京市第一医院)心内科，江苏 南京210006 摘要目的:研究领悟社会支持在肺动脉高压(PAH)患者主观幸福感与心理弹性间的中介效应。方法:选取 2021 年 1 月至 2022 年 10 月在我院接受治疗的 186 例 PAH 患者为研究对象，调查患者一般资料，采用领悟社会支持量表(PSSS)、心理弹性量表(CD-ISC)、纽芬兰纪念大学幸福感量表(MUNSH)评估患者的领悟社会支持、心理弹性和主观幸福感水平。通过 Pearson 相关性分析 PAH 患者心理弹性和社会支持与主观幸福感之间的相关性，通过 Logistic 回归分析建立中介效应模型评估患者心理弹性的影响因素，以及中介路径模型研究领悟社会支持在 PAH 患者主观幸福感与心理弹性间的中介作用。结果:PAH 患者 PSSS 评分为(48.39 5 63)分，CD-ISC 评分为(60 31 5 32)分，MUNSH 评分为(22 39 3 62)分;相关性分析显示PAH 患者的心理弹性、领悟社会支持水平与主观幸福感呈正相关，其心理弹性与领悟社会支持也呈正相关;PAH 患者心理弹性与主观幸福感之间的直接效应系数为 0 54，通过领悟社会支持的间接效应值为 0 25，总效应值为 0 79。结论:领悟社会支持在 PAH 患者主观幸福感与心理弹性间发挥中介作用，医护人员可以通过提高患者心理弹性和领悟社会支持从而提高患者的主观幸福感。494 关键词 肺动脉高压;主观幸福感;心理弹性;领悟社会支持;中介效应 中图分类号395 1 文献标志码A 文章编号1671-7562(2023)04-0494-07doi:10 3969/j issn 1671-7562 2023 04 011Mediating effect of perceived social support betweensubjective well-being and resilience in patients withpulmonary hypertensionYUAN Xialin，QIAO Jimin，ZHOU Xiaoping，HUANG Tianyi，WU Zhiming(Department of Cardiology，Nanjing First Hospital，Nanjing Hospital Affiliated to Nanjing Medical University，Nanjing 210006，China)AbstractObjective:To investigate the mediating effect of perceived social support on subjective well-being andresilience in patients with pulmonary arterial hypertension(PAH)Methods:A total of 186 PAH patients who weretreated in our hospital from January 2021 to October 2022 were selected as the research objects The general data ofthe patients were investigated The perceived social support scale(PSSS)and the Connor-Davidson resilience scale(CD-ISC)and Memorial University of Newfoundland scale of happiness(MUNSH)were used to assess perceivedsocial support，resilience，and subjective well-being Pearson correlation was used to analyze the correlationbetween psychological resilience，social support and subjective well-being in PAH patients，and Logistic regressionanalysis was used to establish a mediating effect model to evaluate the influencing factors of patients mentalresilience The mediating effect of social support on subjective well-being and mental resilience in PAH patientswas studied with the mediating pathway model esults:PSSS score of PAH patients was(48 39 5 63)points，CD-ISC score was(60 31 5 32)points，MUNSH score was(22 39 3 62)points The correlation analysisshowed that the psychological resilience and perceived social support of PAH patients were positively correlated withsubjective well-being，and the psychological resilience and perceived social support were also positively correlatedThe direct effect coefficient between resilience and subjective well-being in PAH patients was 0 54，the indirecteffect value through perceived social support was 0 25，and the total effect value was 0 79 Conclusion:Perceivedsocial support plays a mediating role between subjective well-being and resilience in PAH patients Medical staffcan improve patientsresilience and perceived social support to improve patientssubjective well-being Key words pulmonary arterial hypertension;subjective well-being;resilience;perceived social support;mediating effect肺 动 脉 高 压(pulmonary arterial hypertension，PAH)是一种肺动脉压超过临界值的血流动力学病理疾病。PAH 作为一种常见、多发疾病，患者可伴有呼吸困难、晕厥、心绞痛、咯血等临床症状，重者可引起右心衰竭，具有较高的致残率和致死率1-2。因发病机制复杂、病程较长、治疗困难等特点，PAH 患者的生活质量状况往往较差，且承受巨大的生活压力和经济负担3。提高对 PAH 患者的关注度，及时对 PAH 患者进行干预和救治也成为