家庭功能在股骨颈骨折术后患者创伤后应激障碍与应对方式间的中介效应

Mediating Effect of Family Function on Post Traumatic Stress Disorder and Coping Style in Patients After Femoral Neck Fracture Surgery

目的观察家庭功能在股骨颈骨折(FNF)术后患者创伤后应激障碍(PTSD)与应对方式间的中介效应。方法选取郑州人民医院骨科2018年5月至2021年5月收治的126例FNF术后患者,均获得1个月随访结果,术后1个月时,采用家庭关怀度指数问卷(APGAR)评估患者家庭功能,采用创伤后应激障碍平民版量表(PCL-C)评估患者PTSD,采用简易应对方式问卷(SCSQ)评估患者应对方式,采用中介效应检验程序检验家庭功能在FNF术后患者PTSD与应对方式间的中介效应。结果126例FNF术后患者,APGAR评分为(6.19±1.02)分,PCL-C评分为(54.23±3.52)分,消极应对评分(20.22±2.01)分,积极应对评分(28.96±2.11)分。Pearson直线相关性检验结果显示,APGAR评分分别与PCL-C评分、消极应对评分呈负相关(r<0,P<0.05),与积极应对评分呈正相关(r>0,P<0.05);PCL-C评分与消极应对评分呈正相关(r>0,P<0.05),与积极应对评分呈负相关(r<0,P<0.05);采用方程Y=cX+d_(1)考察PTSD对应对方式的影响,得出回归效应显著;采用方程M=aX+d_(2)考察PTSD对家庭功能的影响,得出回归效应显著;采用方程Y=c’X+bM+d_(3)考察家庭功能在PTSD与应对方式间的中介效应,得出回归效应显著,为部分中介效应模型。结论家庭功能在FNF术后患者PTSD与应对方式间发挥部分中介效应。

Objective To observe the mediating effect of family function between post traumatic stress disorder(PTSD)and coping style in patients after femoral neck fracture(FNF)surgery.Methods A total of 126 patients after FNF treated in the Department of Orthopedics of Zhengzhou People’s Hospital from May 2018 to May 2021 were selected,one month follow-up results were obtained,one month after operation,the family function of patients was evaluated by family care index questionnaire(APGAR),PTSD of patients was assessed with the PTSD checklist-civilian version(PCL-C),coping styles of patients were assessed by simple coping style questionnaire(SCSQ),the mediating effect test procedure was used to test the mediating effect of family function between PTSD and coping style in patients after FNF.Results The APGAR score of 126 patients after FNF was(6.19±1.02),the PCL-C score was(54.23±3.52),the negative coping score was(20.22±2.01)and the positive coping score was(28.96±2.11).Through Pearson linear correlation test,the results showed that APGAR score was negatively correlated with PCL-C score and negative coping score(r<0,P<0.05),and positively correlated with positive coping score(r>0,P<0.05).PCL-C score was positively correlated with negative coping score(r>0,P<0.05),and negatively correlated with positive coping score(r<0,P<0.05).The equation Y=cX+d_(1) was used to investigate the impact of PTSD on coping style,and the regression effect was significant.The effect of PTSD on family function was investigated by equation M=aX+d_(2),and the regression effect was significant.The equation Y=c’X+bM+d_(3) was used to investigate the mediating effect of family function between PTSD and coping style,the regression effect was significant,which was a partial mediating effect model.Conclusion Family function plays a partial mediating effect between PTSD and coping style in patients after FNF.