心理弹性在结直肠癌患者创伤后成长与自我管理效能间的中介效应研究

Study on mediating effect of psychological resilience on post-traumatic growth and self-care self-efficacy in colorectal cancer patients

目的:探讨心理弹性、自我管理效能与创伤后成长三者之间的关系,分析心理弹性在创伤后成长与自我管理效能中的作用。方法:采用创伤后成长量表(PTGI)、心理弹性量表简化版(CD-RISC)、癌症自我管理效能感量表(SUPPH)对2018年8月至2019年3月济南市某所综合医院260名结直肠癌患者进行横断面调查。使用结构方程模型探讨心理弹性在自我管理效能及创伤后成长间的中介作用。结果:结直肠癌患者PTGI得分与CD-RISC、SUPPH得分均呈正相关(P<0.01)。中介效应检验显示,假设模型拟合良好(χ2=61.441,df=39,χ2/df=1.575,GFI=0.959,AGFI=0.930,NFI=0.976,CFI=0.991,RMSEA=0.048)。路径分析表明,自我管理效能可以直接正向预测创伤后成长和心理弹性,又可以通过心理弹性间接作用于创伤后成长,间接效应为0.02,总效应为0.88。结论:结直肠癌患者创伤后成长与心理弹性、自我管理效能三者密切相关,心理弹性可能在创伤后成长和自我管理效能间起部分中介作用。

Objective:To explore the relationship among resilience,self-care self-efficacy and post-traumatic growth,and the mediating role of resilience in them.Methods:260 patients with colorectal cancer were investigated by post-traumatic growth inventory(PTGI),the Connor-Davidson resilience scale(CD-RISC)and the strategies used by people to promote health(SUPPH)in a general hospital in Jinan from August 2018 to March 2019.Structural equation model was used to explore the mediating role of resilience in self-care self-efficacy and post-traumatic growth.Results:PTGI scores were positively correlated with scores of CD-RISC and SUPPH in patients with colorectal cancer(P<0.01).Mediation effect test showed that the model fitted well(χ2=61.441,df=39,χ2/df=1.575,GFI=0.959,AGFI=0.930,NFI=0.976,CFI=0.991,RMSEA=0.048).Path analysis showed that self-care self-efficacy could directly and positively predict post-traumatic growth and resilience(β=0.86,0.31),and indirectly affect post-traumatic growth through resilience,with indirect effect of 0.02 and total effect of 0.88.Conclusion:Post-traumatic growth of patients with colorectal cancer is closely related to psychological resilience and self-care self-efficacy.Psychological resilience may play a mediating role between post-traumatic growth and self-care self-efficacy.