急诊留观患者社会支持对心理健康与应对方式的中介作用

The mediating effect of social support on mental health and coping style of emergency patients

目的探讨急诊留观患者心理健康与应对方式的关系及社会支持的中介作用。方法采用症状自评量表(SCL-90)、社会支持量表(SSRS)和简易应对方式问卷(SCSQ),调查2018年10月-2019年3月陕西省某部队附属医院急诊留观患者共120名,通过建立中介作用方程模型,检验社会支持的中介效应。结果随机抽取120名急诊留观住院患者,平均年龄(38±1.38)岁;男性68人,占56.7%;女性52人,占43.3%;学历主要集中在高中,占30.8%;心理健康测评阳性68人,占56.7%,阴性52人,占43.3%;急诊留观患者躯体化、人际关系敏感、抑郁和焦虑、敌对和精神病性6个因子的得分高于全国成人常模(均P<0.05);心理健康测评阴性留观患者的主观支持及消极应对得分均高于阳性者;积极应对得分低于阳性者(P<0.05);心理健康与积极应对方式呈正相关(均P<0.01),与消极应对方式呈负相关(r=-0.482,P<0.01),与主观支持呈正相关(r=0.520,P<0.01);客观支持与积极应对方式呈正相关(r=0.411,P<0.01),与消极应对方式呈负相关(r=-0.448,P<0.01);采用结构方程模型对两种应对方式的中介作用进行检验,两个模型的各项拟合指标良好,心理健康与应对方式、心理健康与社会支持及应对方式与社会支持之间的路径系数均达到显著水平(P<0.01)。结论心理健康对社会支持、积极应对方式和消极应对方式都有预测作用,同时应注重应对方式的中介作用,通过提高社会支持和采取积极应对方式提高心理健康水平。

Objective To explore the relationship between mental health and coping style,investigate the mediating effect of social support in emergency patients.Methods A total of 120 emergency observation patients in a military Affiliated Hospital of Shaanxi Province from October 2018-March 2019 were investigated,by symptom self-rating scal e(SCL-90),social support scale(SSRS)and simple coping style questionnaire(SCSQ).The mediating effect of social support was tested by established mediating equation model.Results 120 emergency inpatients were randomly selected,with an average age o f(38.0±1.38)years.Among them,68 were male(56.7%),52 were female(43.3%);Education level was mainly concentrated in high schoo l(30.8%);68(56.7%)were positive in mental health assessment,52(43.3%)were negative.The scores of 6 factors,including somatization,interpersonal sensitivity,depression and anxiety,hostility and psychosis,were higher than the national adult norm(all P<0.05).The scores of subjective support and negative coping of patients with negative mental health assessment were higher than those of positive,while positive coping score was lower(P<0.05).Mental health was positively correlated with positive coping style and subjective support(both P<0.01),negatively correlated with negative coping style(r=-0.482,P<0.01).Objective support was positively correlated with positive coping style(r=0.411,P<0.01),and negatively correlated with negative coping style(r=-0.448,P<0.01).The mediating effects of coping styles were tested by structural equation model,and the fitting indexes of the two coping styles were good.The path coefficient among mental health,coping style,and social support,were all reached a significant level(P<0.01).Conclusion Mental health has predictive effect on social support,positive coping style and negative coping style.Meanwhile,we should pay attention to the mediating effect of coping style,and improve the level of mental health by promoting social support and positive coping style.