基于结构方程模型的社会支持、应对方式、抑郁对肺结核患者生活质量的影响

Effects of social support,coping style,and depression on quality of life of tuberculosis patients based on structural equation modeling

目的探讨社会支持、应对方式和抑郁对肺结核患者生活质量的影响。方法采用便利抽样对株洲市某三甲医院收治的肺结核患者202例应用自行设计的一般情况调查表、社会支持量表、医学应对问卷、贝克抑郁自评问卷和健康调查量表(SF-36)进行问卷调查,运用相关分析和结构方程模型建立社会支持、应对方式及抑郁对肺结核患者生活质量影响的关系模型。结果肺结核患者社会支持总分(33.83±8.9)分;医学应对方式面对维度(18.18±3.98)分,回避维度(15.26±2.78)分,屈服维度(10.11±3.62)分;贝克抑郁问卷总得分(9.68±7.95)分;SF-36总得分(45.84±23.42)分。结构方程模型显示,社会支持对生活质量有直接正向效应(P<0.05),并能通过屈服应对方式、抑郁间接影响生活质量(P<0.01);抑郁对生活质量有直接的负向效应(P<0.01);屈服应对方式通过抑郁间接影响生活质量(P<0.01)。结论社会支持对生活质量有直接和间接影响,屈服应对方式对生活质量有间接影响,抑郁分别作为中介变量调节社会支持与生活质量,屈服应对方式与生活质量的关系。

Objective To explore the effects of social support,coping styles and depression on the quality of life of patients with pulmonary tuberculosis.Methods A convenience sample of 202 patients with pulmonary tuberculosis admitted to a tertiary hospital in Zhuzhou City applied self-designed general information questionnaire,social support scale,medical coping questionnaire,Beck depression self-assessment questionnaire and the MOS item short form health survey(SF-36)to conduct a questionnaire survey.The relationship model of the influences on the quality of life for tuberculosis patients was built by correlation analysis and structural equation model.Results The total score of social support was(33.83±8.9);medical coping style face dimension(18.18±3.98),avoiding(15.26±2.78)and yielding(10.11±3.62).Beck depression questionnaire total score was(9.68±7.95),the total score of SF-36 was(45.84±23.42).The structural equation model showed social support had a direct positive effect on the quality of life for pulmonary tuberculosispatients(P<0.05),and had an indirect effect on quality of life for patientsthrough both yield coping style and depression(P<0.01);depression had a direct negative effect on quality of life for pulmonary tuberculosispatients(P<0.01);yield coping style had an indirect affect on quality of life through depression(P<0.01).Conclusions Social support had a direct and indirect effect on quality of life,and yielding coping style had an indirect effect on quality of life.Depression moderated the relationship between social support and quality of life as a mediator,and yielding coping style and quality of life as a mediator.