心理弹性在腰椎间盘突出症术后患者家庭功能与出院准备度中的中介效应

Mediating effect of resilience on family function and readiness for hospital discharge in lumbar disc herniation patients after surgery

目的了解腰椎间盘突出症术后患者出院准备度现状,并构建结构方程模型探讨心理弹性在家庭功能与出院准备度间的中介作用。方法于2018年1月—2019年3月方便抽取某三级甲等医院脊柱外科住院进行手术治疗的腰椎间盘突出症患者212例,采用家庭关怀指数问卷、心理弹性量表、出院准备度量表对其进行调查。结果腰椎间盘突出症术后患者家庭功能得分为(7.14±2.05)分,心理弹性得分为(54.29±7.23)分,出院准备度得分为(88.79±8.99)分。患者家庭功能与心理弹性(r=0.401,P<0.01)、出院准备度(r=0.459,P<0.01)呈正相关,心理弹性与出院准备度呈正相关(r=0.561,P<0.01);心理弹性在家庭功能与出院准备度间起部分中介作用,中介效应占总效应的42.18%。结论家庭功能既可正向预测患者的出院准备度,又能通过心理弹性间接影响出院准备度。护士应重视患者家庭功能和心理弹性的评估,通过提高患者家庭功能和心理弹性,进而提高患者出院准备度。

Objective To understand the readiness for hospital discharge in lumbar disc herniation(LDH)patients after surgery and to explore the mediating effect of resilience on family function and readiness for hospital discharge by constructing structure equation model.Methods From January 2018 to March 2019,we selected 212 LDH patients undergoing surgery in Spine Surgery Department at a ClassⅢGrade A hospital by convenience sampling.All of patients were investigated with the Family APGAR Index(APGAR),Connor-Davidson Resilience Scale(CD-RISC)and Readiness for Hospital Discharge Scale(RHDS).Results Among those LDH patients after surgery,the scores of family function,resilience and readiness for hospital discharge were(7.14±2.05),(54.29±7.23)and(88.79±8.99)respectively.Family function of patients had positive correlations with resilience(r=0.401,P<0.01)and readiness for hospital discharge(r=0.459,P<0.01);resilience had a positive correlation with readiness for hospital discharge(r=0.561,P<0.01).Readiness had a partial mediating effect on family function and readiness for hospital discharge accounting for 42.18%of the total effect.Conclusions Family function not only can positively forecast patients'readiness for hospital discharge,but also has the indirect impact on readiness for hospital discharge by readiness.Nurses should pay attention to the assessment for family function and resilience,and improve patients'readiness for hospital discharge by the improvement of family function and resilience.