领悟社会支持及应对方式在恶性血液病行造血干细胞移植患者心理弹性与创伤后成长间的中介效应

Perceived Social Support and Coping Style as Mediators between Resilience and Post-traumaticGrowth among Patients with Hematopoietic Stem Cell Transplant

目的评估恶性血液病行造血干细胞移植患者的创伤后成长水平,探讨恶性血液病造血干细胞移植患者领悟社会支持、应对方式及心理弹性状况与创伤后成长之间的内在关联,明确其中介效应。方法采用方便抽样方法,于2016年7—12月选取207例造血干细胞移植患者,采用创伤后成长量表、领悟社会支持量表、应对方式量表及心理弹性量表对其进行问卷调查。结果造血干细胞移植患者创伤后成长总分为(73.31±16.45)分,领悟社会支持总分为(66.51±11.45)分,应对方式总分为(54.75±6.57)分,心理弹性得分为(29.34±7.17)分。造血干细胞移植患者创伤后成长与领悟社会支持、应对方式、心理弹性总分均呈密切正相关(r=0.441～0.551,均P<0.01)。构建中介模型显示,心理弹性对创伤后成长有正向预测作用(β=0.535,P<0.01),应对方式对创伤后成长有正向预测作用(β=0.297,P<0.01),心理弹性对社会支持有正向预测作用(β=0.563,P<0.01),领悟社会支持、应对方式在造血干细胞移植患者心理弹性与创伤后成长间起中介作用。结论造血干细胞移植患者创伤后成长、社会支持、应对方式、心理弹性得分均处于在中等偏上水平,且创伤后成长与领悟社会支持、应对方式、心理弹性总分均呈密切正相关,领悟社会支持、应对方式在恶性血液病行造血干细胞移植患者心理弹性与创伤后成长间存在中介效应。医护人员可采用积极手段来提高患者心理弹性,增强社会支持力度,引导其采用积极应对方式面对困境,从而培养创伤后成长。

Objective To assess post-traumatic growth(PTG)of hematopoietic stem cell transplant(HSCT)patients with hematologic malignancies,to explore its intrinsic relationship with perceived social support,coping style and psychological resilience and to identify the mediating role of perceived social support and coping style.Methods With convenient sampling method,the 207 HSCT patients were selected from July to December 2016 and they were investigated by using the Posttraumatic Growth Inventory(PTGI),Perceived Social Support Scale(PSSS),Medical Coping Modes Questionnaire(MCMQ)and the score of the 10-item Connor-Davidson Resilience Scale(CD-RISC10).Results The total score of PTGI in HSCT patients was 73.31±16.45,and that of PSSS was 66.51±11.45,the total score of MCMQ was 54.75±6.57,and the score of CD-RISC10 29.34±7.17.The scores of PTGI,PSSS,MCMQ and CD-RISC10 of HSCT patients were significantly positively correlated(r=0.441~0.551,all P<0.001).The constructed mediation model showed that resilience(β=0.535,P<0.01)and coping style(β=0.297,P<0.01)had a positively predictive effect on PTG and resilience had had a positively predictive effect on social support(β=0.563,P<0.01).Perceived social support and coping style played a mediating role in the psychological resilience and PTG of HSCT patients.Conclusion Score of PTG,social support,coping style and resilience of HSCT patients is in a mediate or above level.PTG is significantly positively correlated with perceived social support,coping style and resilience.Perceived social support and coping style play a mediating role in the psychological resilience and PTG of HSCT patients.Positive measures are proposed to take to improve patients’psychological resilience and social support,and guide them to adopt a positive coping style to face difficulties,so as to cultivate PTG.