医学应对方式、社会支持对肾移植患者生活质量影响的路径分析

Path analysis on relationship between medical coping modes,social support and quality of life for renal transplant patients

目的探讨医学应对方式、社会支持与肾移植患者生活质量的关系。方法采用方便抽样方法,应用医学应对问卷(Medical Coping Modes Questionnaire,MCMQ)、社会支持量表(Social Support Rating Scale,SSRS)和肾移植患者生活质量相关评定量表(Quality of Life Scale for Patients of Renal Transplantation,QOL-RT)对123名肾移植患者进行测评,然后用结构方程模型分析软件Amo(sAnalysis of Moment Struc-tures)7.0作路径分析。结果肾移植患者医学应对方式中,面对维度得分为(20.89±3.60)分、回避维度得分(17.15±2.73)分、屈服维度得分(9.50±2.74)分;社会支持总分(42.89±8.48)分;总的生活质量(128.74±16.29)分。路径分析结果显示:回避维度对生活质量有直接正向效应(β=0.183,P<0.01),屈服维度对生活质量有直接负向效应(β=-0.388,P<0.01);面对维度对社会支持有直接正向效应(β=0.232,P<0.01);屈服维度对社会支持有直接负向效应(β=-0.203,P<0.01);而社会支持对生活质量有直接正向效应(β=0.428,P<0.01);医学应对方式还可通过社会支持间接影响生活质量。结论医学应对方式对肾移植患者的生活质量有直接效应;医学应对方式还可通过社会支持间接影响肾移植患者的生活质量;社会支持可作为中介变量(Mediated variable)调节应对方式与肾移植患者生活质量的关系。

【Objective】 To explore the relationship between medical coping modes,social support and quality of life for renal transplant patients.【Methods】 Through convenient sampling,123 renal transplant patients were evaluated by Medical Coping Modes Questionnaire （MCMQ）,Social Support Rating Scale （SSRS） and Quality of Life Scale for Patients of Renal Transplantation （QOL-RT）.A path analysis was applied by AMOS （Analysis of Moment Structures） version 7.0.【Results】The mean score of three dimensions of MCMQ for renal transplant patients were：face（20.89±3.60）,avoid （17.15±2.73）and surrender（9.50±2.74）,respectively.The total mean score of SSRS for renal transplant patients was （42.89±8.48）.The total mean score of QOL for renal transplant patients was （128.74±16.29）.Path analysis showed that avoid had directly positive effects on QOL （β =0.183,P 〈0.01）,surrender had directly negative effects on QOL （β =-0.388,P 〈0.01）,face had directly positive effects on social support （β =0.232,P 〈0.01）,surrender had directly negative effects on social（β =-0.203,P 〈0.01）,and social support had directly positive effects on QOL （β =0.428,P 〈0.01）.Medical coping modes had indirect effects on QOL through social support path.【Conclusion】Medical coping modes has direct effects on QOL for renal transplant patients.Medical coping modes has indirect effects on QOL for renal transplant patients.Social support as a mediated variable mediates the relationship between Medical coping modes and QOL for renal transplant patients.