照顾者反应对颈髓损伤伴截瘫患者心理韧性的影响

The influencing factors of caregiver reaction on resilience among cervical spinal cord injury patients with paraplegia

目的 :调查颈髓损伤伴截瘫患者照顾者反应和患者心理韧性现状,并分析照顾者反应对患者心理韧性的影响。方法 :采用中文版CD-RISC心理韧性量表和中文版照顾者反应评估量表对203例颈髓损伤伴截瘫患者及其照顾者进行问卷调查。结果 :颈髓损伤伴截瘫患者照顾者的健康问题(10.96±2.39)分,时间安排受打扰(16.34±3.60)分,经济问题(7.74±1.30)分,家庭支持缺乏(17.91±4.22)分,自尊(26.76±6.42)分。患者心理韧性总分为(62.80±17.65)分。照顾者的健康问题、时间安排受打扰、经济问题、家庭支持缺乏与患者的坚韧性、力量、乐观及心理韧性总分均呈显著负相关(P<0.05),与自尊呈显著正相关(P<0.05)。分层回归分析结果显示,照顾者反应各维度可联合解释颈髓损伤伴截瘫患者心理韧性总变异的24.4%。结论 :颈髓损伤伴截瘫患者心理韧性水平不容乐观,照顾者反应为其心理韧性的影响因素,可从照顾者反应入手来改善其心理韧性水平。

Objective： To investigate the current status of caregiver reaction and resilience among cervical spinal cord injury patients with paraplegia, and to explore the influencing factors of caregiver reaction on resilience. Methods： Totally 203 cervical spinal cord injury patients with paraplegia and their caregivers were recruited and investigated by the ConnorDavidsen Resilience Scale and the Caregiver Reaction Assessment Scale. Results： The scores of health problems, disturbed time arrangements, economic problems, lack of family support, and self-esteem were 10.96±2.39, 16.34±3.60, 7.74±1.30, 17.91±4.22 and 26.76±6.42, respectively. The total score of resilience was 62.80±17.65. The scores of health problems, disturbed time arrangements, economic problems, lack of family support were negatively correlated with the scores of tenacity, strength, optimism and total score of resilience（P〈0.05）, while the score of self-esteem were positively correlated with the scores of tenacity, strength, optimism and total score of resilience（P〈0.05）. Hierarchical regression analysis showed that all the dimensions of caregiver reaction could explained 24.4% of the total variance of the resilience among cervical spinal cord injury patients with paraplegia（P〈0.05）. Conclusions： The resilience among cervical spinal cord injury patients with paraplegia was in the middle level, and the caregiver reaction is an important influencing factor of resilience. The nursing staff could improve the level of patients＇ resilience by handling with their caregiver reaction.