ICU患者应对方式和心理资本对自我感受负担影响的路径分析

Path analysis of the effects of coping style and psychological capital on self-perceived burden in ICU patients

目的分析ICU患者自我感受负担现状,分析应对方式、心理资本与自我感受负担的路径关系。方法选取2020年4至7月浙江大学医学院附属杭州市第一人民医院70例、温州医科大学附属第二医院50例、浙江大学医学院附属第一医院20例、杭州市余杭区第一人民医院10例的ICU患者共150例。应用一般资料问卷、积极心理资本问卷、医学应对方式问卷和自我感受负担量表作为研究工具进行问卷调查,并进行相关性分析及构建结构方程模型。结果ICU患者心理资本总条目均分(4.33±0.66)分,心理资本4个维度条目均分从高到低依次为乐观、韧性、希望、自我效能。ICU患者应对方式总条目均分(2.41±0.18)分,应对方式3个维度条目均分由高到低依次为:屈服、回避、面对。ICU患者自我感受负担维度得分为(33.62±9.18)分。心理资本总分与自我感受负担呈负相关(r=-0.455,P<0.01)。应对方式中面对与心理资本总分均呈正相关(r=0.643,P<0.01),与自我感受负担呈负相关(r=-0.396,P<0.01)。结构方程显示,ICU患者心理资本在应对方式与自我感受负担之间存在部分中介作用,中介效应占总效应的82.3%。结论护理管理者应及时识别ICU患者的自我感受负担程度,引导采用面对的应对方式,并采取相应的干预措施提高其心理资本,从而降低患者的自我感受负担程度,最终提高患者生活质量,促进疾病的进程和转归。

Objective To investigate the status of self-perceived burden of ICU patients,and to analyze the path relationship between coping style psychological capital and self-perceived burden.Methods Using convenience sampling method,150 ICU patients admitted in 4 tertiary a hospitals in Zhejiang Province were selected as the research objects between April to July 2020.The questionnaires of general information,positive psychological capital and medical coping style were used in the survey,and patients were assessed with self-perceived burden scale.The correlation analysis was performed and the structural equation model was constructed.Results The mean overall score of psychological capital in ICU patients was(4.33±0.66),and among the 4 dimensions of psychological capital the score of optimism was the highest,followed by resilience,hope and self-efficacy.The mean overall score of copping in ICU patients was(2.41±0.18),and among 3 dimensions of response methods,the score of yield was the highest,followed by avoidance and facing.The dimension of self-perceived burden of ICU patients was scored as(33.62±9.18).The overall score of psychological capital was negatively associated with the self-perception burden(r=-0.455,P<0.01).The response method was positively correlated with the overall score of psychological capital(r=0.643,P<0.01)and negatively correlated with self-perception burden(r=-0.396,P<0.01).Structural equation showed that psychological capital had a partial mediating role between coping style and self-perceived burden of ICU patients,and the mediation effect accounted for 82.3%of the total effect.Conclusion Nursing managers should timely identify the degree of self-perceived burden of ICU patients,to guide the adoption of face coping methods,and take appropriate intervention measures to improve their psychological capital,so as to reduce the degree of self-perceived burden,ultimately improve the quality of life of patients,promote the process and outcome of the disease.