脑卒中患者领悟社会支持与抑郁间的中介效应及心理弹性的调节效应

Mediating Effect between Perceived Social Support and Depression among Stroke Patients and the Moderating Effect of Resilience

目的探讨睡眠质量在脑卒中患者领悟社会支持和抑郁间的中介效应及心理弹性的调节效应。方法2020年9月至2021年1月,采用便利抽样法选取大庆市某三级甲等医院收治的243例脑卒中患者为研究对象,使用领悟社会支持量表、匹兹堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)、心理弹性量表、Zung抑郁自评量表对其进行调查。结果领悟社会支持与PSQI得分、抑郁呈负相关,与心理弹性呈正相关;PSQI得分与抑郁呈正相关,与心理弹性呈负相关;心理弹性与抑郁呈负相关,均P<0.05。领悟社会支持对抑郁的直接作用显著(P<0.001),睡眠质量在领悟社会支持与抑郁间发挥部分中介作用,占总效应的14.48%。心理弹性水平较高时,领悟社会支持对PSQI得分有负向预测作用(P<0.001),且PSQI得分对抑郁具有正向预测作用(P<0.001)。结论脑卒中患者的领悟社会支持水平不仅直接作用于抑郁,还可通过睡眠质量的中介作用间接影响抑郁,且这一过程受心理弹性的调节。

Objective To explore the mediating effect of sleep quality between perceived social support and depression,and the moderating effect of resilience among stroke patients.Methods Convenience sampling was used to select 243 stroke patients from a tertiary hospital in the Daqing City from September,2020 to January,2021.The Perceived Social Support Scale,Pittsburgh Sleep Quality Index(PSQI),Connor-Davidson Resilience Scale and Zung Self-Rating Depression Scale were used for investigation.Results The perceived social support was negatively correlated with the scores of PSQI and depression,and positively correlated with resilience;the PSQI score was positively correlated with depression and negatively correlated with resilience;resilience was negatively correlated with depression(all P<0.05).The direct effect of perceived social support on depression was statistically significant(P<0.001).Sleep quality played a partial mediating role between perceived social support and depression,accounting for 14.48%of the total effect.When the level of resilience was higher,perceived social support reported a negatively predictive effect on the PSQI score(P<0.001),and the PSQI score reported a positively predictive effect on depression(P<0.001).Conclusions Stroke patients’perceived social support can not only directly affect depression,but also indirectly affect depression through the mediating role of sleep quality,which is moderated by resilience.