伤残接受度与心理弹性对喉癌永久性气管造瘘患者病耻感影响的路径分析

Path analysis on influence of disability acceptance and resilience on stigma in laryngeal carcinoma patients with permanent tracheostomy

目的探讨伤残接受度与心理弹性对喉癌永久性气管造瘘患者病耻感影响,并分析其影响路径。方法采用便利抽样法,选取2016年6—2018年8月在广西医科大学附属肿瘤医院住院部及门诊部就诊的喉癌永久性气管造瘘患者264例为研究对象。采用社会影响量表(SIS)、伤残接受度量表(AODS)、心理弹性量表(CD-RISC10)对其进行调查,对三者进行相关性分析并建立结构方程模型进行路径分析。发放264份调查问卷,有效回收256份。结果256例永久性气管造瘘患者病耻感、伤残接受度、心理弹性总分分别为(61.50±9.27)、(76.88±9.34)、(26.49±4.05)分。相关性分析显示,伤残接受度、心理弹性得分与病耻感呈负相关(P<0.01)。结构方程模型分析表明,喉癌气管造瘘患者伤残接受度和心理弹性对病耻感具有直接效应(β值分别为-0.43、-0.28),伤残接受度通过心理弹性间对病耻感的间接效应为-0.06。结论喉癌永久性气管造瘘患者病耻感水平较高,伤残接受度与心理弹性对病耻感有显著预测作用。

Objective To explore the influence of disability acceptance and resilience on stigma in laryngeal carcinoma patients with permanent tracheostomy and analyze the impact path.Methods From June 2016 to August 2018,this study selected 264 laryngeal carcinoma patients with permanent tracheostomy of Inpatient and Outpatient Department in Guangxi Medical University Affiliated Tumor Hospital as subjects by convenience sampling.All patients were investigated with the Social Impact Scale(SIS),Acceptance of Disability Scale(AODS)and the 10-item Connor-Davidson Resilience Scale(CD-RISC10).The correlations were analyzed and structure equation model was used to path analysis.A total of 264 questionnaire were sent out and 256 valid questionnaires were collected.Results Among those patients with permanent tracheostomy,the total scores of stigma,disability acceptance and resilience were(61.50±9.27),(76.88±9.34)and(26.49±4.05)respectively.Correlation analysis showed that the scores of disability acceptance and resilience had negative correlations with stigma with statistical differences(P<0.01).Structure equation model analysis showed that disability acceptance and resilience of laryngeal carcinoma patients with permanenttracheostomy had direct effect on stigma(β=-0.43,-0.28),the indirect effect of disability acceptance on stigma by resilience was-0.06.Conclusions Laryngeal carcinoma patients with permanenttracheostomy have a high level of stigma,the disability acceptance and resilience has significant roles on stigma.