基于结构方程模型围绝经期女性疲乏的影响因素分析

Factors associated with fatigue among perimenopausal women based on structural equation model

目的通过构建结构方程模型了解围绝经期女性疲乏影响因素的作用路径及效应大小,为改善该人群疲乏状况提供理论依据。方法采用分层整群抽样的方法,使用一般资料调查表、中文版多维度疲乏症状量表-简表、改良围绝经期症状量表、社会支持评定量表、家庭关怀度指数量表、匹兹堡睡眠质量指数量表、流调中心抑郁自评量表对河北省唐山市梁家屯社区、朱庄子村和蒋各庄村的580名围绝经期女性进行问卷调查,使用AMOS 22.0软件构建结构方程模型,分析围绝经期女性疲乏的影响因素及作用路径。结果被调查的围绝经期女性疲乏得分为(15.41±13.01)分。结构方程模型拟合较好(AGFI=0.975、CFI=0.999、RMSEA=0.044),各因素对疲乏的影响效应由大到小依次为围绝经期症状、抑郁、家庭关怀度、睡眠质量、社会支持,其中睡眠质量对疲乏具有最强的直接正向效应,围绝经期症状通过家庭关怀度、社会支持、抑郁及睡眠质量产生间接效应;抑郁通过社会支持及睡眠质量产生间接效应;家庭关怀度通过社会支持、抑郁及睡眠质量产生间接效应。结论围绝经期女性疲乏受生理、心理、环境因素影响,改善围绝经期症状、提高睡眠质量、调节负性情绪、促进家庭和睦、鼓励积极参与社会活动是缓解疲乏感的有效途径。

Objective To explore the pathways and effects of factors associated with fatigue among perimenopausal women through constructing structural equation model,so as to provide theoretical evidence for improving their situation.Methods Stratified cluster sampling was used to recruit 580 perimenopausal women at Liangjiatun community,Zhuzhuangzi village and Jianggezhuang village in Tangshan,Hebei.Questionnaire survey was used to collect data including general information,the Chinese version of multidimensional fatigue symptoms scale(short),the improvement of symptoms of the menopausal transition scale,social support rating scale,family care index scale,Pittsburgh sleep quality index scale,and flow adjustable center depression self rating scale.AMOS 22.0 was used to construct structural equation model to analyze the factors and the action path associated with fatigue.Results The score of fatigue among perimenopausal women was(15.41±13.01).The structural equation model fitted well(AGFI=0.975,CFI=0.999,RMSEA=0.044).The effects of each factor on fatigue from high to low were perimenopausal symptoms,depression,family care,sleep quality and social support,respectively of whih sleep quality had the strongest direct positive effect on fatigue.Perimenopausal symptoms had indirect effects through family care,social support,depression and sleep quality.Depression had indirect effects through social support and sleep quality.Family care had indirect effects through social support,depression and sleep quality.Conclusion Perimenopausal women’s fatigue is affected by physiological,psychological and environmental factors.Alleviating perimenopausal symptoms,improving sleep quality,regulating negative emotions,promoting family harmony and encouraging active participation in social activities are effective ways to relieve fatigue.