慢性心力衰竭患者和家庭照顾者相依关系对双方正性情绪及积极应对方式的影响

Influence of mutuality between patients with chronic heart failure and family caregivers on their positive emotions and positive coping styles

目的:基于主客体互倚模型(APIM)分析慢性心力衰竭(CHF)患者和家庭照顾者的相依关系对双方正性情绪及积极应对方式的影响。方法:本研究为横断面研究。采用便利抽样法,选取2020年1—7月于南京医科大学第一附属医院心内科住院的101对CHF患者及其家庭照顾者作为调查对象。采用自制一般资料调查表、相依关系量表、中文版正负情绪量表和中文版简易应对方式量表对CHF患者及其家庭照顾者进行横断面调查,并建立相依关系对正性情绪及积极应对方式的APIM。结果:在主体效应方面,CHF患者及其家庭照顾者的相依关系均可影响自身的正性情绪(回归系数分别为3.922、3.427;P<0.01)和积极应对方式(回归系数分别为2.936、2.828;P<0.01);在客体效应方面,家庭照顾者的相依关系可影响CHF患者的正性情绪(回归系数为2.744,P<0.01)和积极应对方式(回归系数为2.198,P<0.05)。结论:CHF患者的情绪和应对行为受到自身和家庭照顾者所感知相依关系的正向影响,提示临床工作者应重视CHF家庭照护中相依关系的评估,积极探索以相依关系为焦点的干预方案。

Objective To explore the influence of mutuality between patients with chronic heart failure(CHF)and family caregivers on their positive emotions and positive coping styles based on the actor-partner interdependence model(APIM).Methods This study was a cross-sectional study.From January to July 2020,convenience sampling was used to select 101 pairs of CHF patients and their family caregivers in the Department of Cardiovascular of the First Affiliated Hospital with Nanjing Medical University.The self-designed General Information Questionnaire,the Mutuality Scale(MS),the Chinese version of Positive and Negative Affect Scale(PANAS)and the Chinese version of Simple Coping Style Questionnaire(SCSQ)were used to conduct a cross-sectional survey of patients with heart failure and their family caregivers,and we established the APIM for the mutuality to positive emotions and positive coping styles.Results In terms of the actor effect,the mutuality of CHF patients and their family caregivers could affect their own positive emotions(regression coefficients were 3.922,3.427;P<0.01)and positive coping styles(regression coefficients were 2.936,2.828;P<0.01).In terms of the partner effect,the mutuality of family caregivers could affect the positive emotions(regression coefficient was 2.744,P<0.01)and positive coping styles(regression coefficient was 2.198,P<0.05)of CHF patients.Conclusions CHF patients'emotions and coping behaviors are positively affected by the perceived mutuality between themselves and family caregivers,suggesting that clinicians should pay attention to the evaluation of the mutuality in CHF family care and actively explore intervention programs focusing on the mutuality.