不同应对方式在结肠造口患者病耻感和造口适应间的中介效应

The Mediating Effects of Different Coping Style Between Stigma and Adjustment Level Among Patients With Colostomy

目的探讨应对方式在结肠造口患者病耻感和造口适应之间的中介作用,并比较其效果量。方法 2016年8月至2017年1月,便利抽样选取某医院结肠造口患者228例,采用社会影响量表、医学应对方式问卷、造口适应量表测量其病耻感、应对方式和造口适应水平,使用Mplus 7.0建立中介作用模型。结果结肠造口患者的病耻感、应对方式对其造口适应有直接影响;病耻感以应对方式的3个维度(面对、回避、屈服)为中介变量,对造口适应产生间接影响,间接效应效果量为37.3%;通过屈服维度的效果量最大,为22.3%。结论医护人员应当重视病耻感对造口适应的影响,在总结不同作用路径的基础上,开展以路径为依托的干预,提高患者的适应水平。

Objective To explore the mediating effects of different coping style between stigma and adjustment level among patients with colostomy and compare their effects.Methods By convenience sampling,228 patients were selected and investigated by using social impact scale(SIS),medical coping modes questionnaire(MCMQ)and ostomy adjustment scale(OAS).The data was analyzed by Mplus7.0.Results Stigma and coping style among patients with colostomy could predict adjustment level directly.Through the mediating role of coping style(confrontation,avoidance,yield),stigma played a role in adjustment level indirectly with effect size of 37.3%,among which the mediating path through yield has the greatest effect of 22.3%.Conclusion Medical personnel should pay more attention to the effect of stigma on adjustment level among patients with colostomy.Based on different paths,they should improve the adjustment level of the patients through path-based intervention.