勃起功能障碍患者病耻感的影响因素分析

Influencing factors of stigma in patients with erectile dysfunction

目的基于结构方程模型探讨勃起功能障碍(ED)患者的社会支持、一般自我效能、应对方式及病耻感水平之间的关系。方法选取2020年8月至2021年5月江苏省南京市某三级甲等医院诊治的200例ED患者作为研究对象。采用一般基本情况量表、社会支持评定量表、一般自我效能量表、应对方式问卷、社会影响量表对这200例ED患者进行调查。结果影响ED患者病耻感的因素依次为社会支持、自我效能、消极应对方式。社会支持(B=-0.732,P<0.01)、一般自我效能(B=-0.051,P<0.01)、消极应对方式(B=0.031,P<0.01)可显著预测病耻感水平;社会支持通过一般自我效能对ED患者病耻感的间接效应显著,其95%置信区间为(-0.397,-0.056),社会支持通过消极应对方式对患者病耻感水平的间接效应显著,其95%置信区间为(-0.207,-0.024),自我效能、消极应对的中介效应占总效应的百分比为34.3%。结论护理人员在临床上应该开展以影响患者病耻感水平的路径为依据的干预措施,通过增加患者的社会支持,从而提高其自我效能感,转变其应对方式,最终降低患者病耻感水平。

Objective To explore the relationship among social support, general self-efficacy, coping style and stigma in patients with erectile dysfunction based on structural equation model. Methods A total of 200 patients with erectile dysfunction diagnosed and treated in a tertiary hospital in Nanjing, Jiangsu Province from August 2020 to May 2021 were selected as the research objects. The general basic situation scale, social support scale, general self-efficacy scale, coping style questionnaire and social impact scale were used to investigate 200 patients with erectile dysfunction.Results The influencing factors of stigma in ED patients were social support, self-efficacy and negative coping style. Social support(B=-0.732,P<0.01), general self-efficacy(B=-0.051,P<0.01) and negative coping style(B=0.031,P<0.01) can significantly predict stigma;Social support has a significant indirect effect on the level of stigma in patients with erectile dysfunction through general self-efficacy, and the 95% confidence interval was(-0.397,-0.056).Social support has a significant indirect effect on the level of stigma through negative coping style, and its 95% confidence interval is(-0.207,-0.024). The mediating effect of self-efficacy and negative coping accounted for 34.3% of the total effect.Conclusions Nursing staff should carry out intervention measures based on the path of influencing the level of stigma of patients in clinical practice, by increasing the social support of patients, so as to improve their self-efficacy, change their coping style, and ultimately reduce the level of stigma of patients.