自我效能和应激对胆结石患者生活质量的影响

Correlation between stress, self efficacy and quality of life in patients with gallstone

目的：探讨胆结石患者应激、自我效能对其生活质量影响,分析自我效能在应激与患者生活质量中的效应关系,为胆结石患者健康干预提供指导。方法对温州医科大学第二附属医院肝胆外科362例术后胆结石回归社区12个月的患者进行调查,采用生活事件量表测量患者的应激状况、自我效能量表测量自我效能、消化道生存质量的量表（ GIQLI）测量术后生活质量状况,分析自我效能在应激与患者生活质量中的效应关系。结果自我效能感在应激和生活质量间起部分中介效应,当加入中介变量自我效能感后,生活质量与应激之间的回归系数明显降低（β值从－0.695降低到－0.548）。自我效能在应激与生活质量间起调节效应,即自我效能感×应激偏回归系数在以生活质量为因变量的回归中达到显著性水平（β＝－0.086,P〈0.05）,且引入交互作用项后新增解释量（△R2）亦达到显著性水平（△R2＝0.017,P〈0.05）。结论自我效能感在应激和生活质量的关系中起中介效应和调节效应,护理人员可以通过干预患者的自我效能感降低应激事件给患者生活质量带来的负面影响。

Objective To explore the effects of stress and self-efficacy on the quality of life in patients with gallstones and the effect relationship of self-efficacy in the quality of life and stress, and provide guidance＆amp;nbsp;for the health intervention of patients with gallstones. Methods Totally 362 patients with gallstones after operative that already returned to the community for 12 months were investigated, and their stress condition, self-efficacy and quality status of life were measured by the life events scale （ LES ） , self-efficacy scale and gastrointestinal quality of life index （GIQLI）. The effect relationship of self-efficacy in the quality of life and stress was analyzed.Results The self-efficacy played partial mediating effect between stress and quality of life. When the intermediary variables-self-efficacy sense was participated in, the regression coefficient between stress and quality of life was significantly reduced （β was reduced from -0. 695 to -0. 548 ） . Self efficacy played regulating effect between stress and quality of life, which means that self efficacy sense × stress partial regression coefficient in the regression which regard the quality of life as the dependent variable can reach to a significant level （β=-0.086, P〈0.05） , and introduced interaction terms after new interpretation （△R2 ） also can reach to a significant level （△R2 = 0. 017, P〈0. 05 ） . Conclusions Self efficacy played the mediating effect and regulating effect in the relationship between stress and quality of life. Nursing staff can reduce the negative effects of stress events in patients′quality of life through the interventions in patients′self-efficacy.