慢性心力衰竭患者自我概念、抑郁和自我护理行为的路径分析

Path analysis of self-concept and depression on self-care in patients with chronic heart failure

目的探讨慢性心力衰竭患者自我概念、抑郁对自我护理行为的关系效应及影响路径。方法采用Artinian心力衰竭自我护理行为量表、自我概念量表和综合性医院焦虑抑郁量表（HADS），对北京市某心血管病专科医院160例慢性心力衰竭住院患者进行测评。采用Amos17．0进行路径分析。结果体觉、理想自我、道德-伦理-精神自我、自我一致性对自我护理行为具有直接效应，其中前三者还通过抑郁对自我护理行为具有间接效应。体觉、自我一致性、理想自我、道德-伦理-精神自我、抑郁对自我护理行为的总体效应分别为0．09，0．15，0．31，0．09和-0．26。结论慢性心力衰竭患者的自我护理行为受到自我概念和抑郁直接、间接影响，应从多途径多环节采取干预措施提高心力衰竭患者的自我护王旱．

Objective To explore the role of depression as a moderator of self-concept on self-care behaviors in patients with chronic heart failure （CHF）. Methods A sample of 160 in-patients with CHF were recruited from a cardiovascular hospital in Beijing. Data were collected by self-report questionnaires assessing self-care be- haviors, self-concept and depression. Analysis of Moment Structures （AMOS） version 17.0 software was used to conduct the path analyses. Results Body sensation, self-consistency, self-ideal, moral-ethical-spiritual self and depression revealed direct effects on self-care behavior. Body sensation, self-ideal, moral-ethical-spiritual self affected self-care indirectly via depression. These paths total coefficients were 0. 09 ,0.15 ,0. 31,0. 09 and - 0.26, respectively. Conclusion Self-care behaviors are directly affected by self-concept and depression. Depression has a greater moderating effect on these relationships. The findings provide a theoretical basis to direct the development of interventions for improving self-care in individuals with heart failure.