自尊在高血压患者社交焦虑与睡眠质量间的中介效应

Intermediary role of self-esteem of hypertensive patients in relationship between social anxiety and sleep quality

目的探讨自尊对高血压患者社交焦虑与睡眠质量的影响并建立结构方程模型,为高血压患者健康干预提供依据。方法采用整群抽样方法,选择2021年7—10月在皖南医学院弋矶山医院住院治疗的高血压患者340例作为研究对象,运用自尊量表(SES)、社交焦虑量表(SPIN)、匹兹堡睡眠质量指数量表(PSQI)调查高血压患者,并使用SPSS 25.0软件分析数据,Amos 21.0软件构建结构方程模型。结果有效回收问卷333份,相关性分析显示,高血压患者睡眠质量、自尊和社交焦虑任意两者之间均为线性相关(P<0.05),自尊与睡眠质量、社交焦虑呈负相关(r=-0.298,P<0.01;r=-0.305,P<0.01),社交焦虑和睡眠质量呈正相关(r=0.134,P<0.05)。多元回归分析显示,高血压患者性别及自尊对睡眠质量有预测作用,可以解释睡眠质量10.90%的变异量(P<0.05)。结构方程模型显示:社交焦虑对自尊的直接效应为-0.40(P<0.05),可以解释高血压患者自尊的15.70%的变异量;自尊对睡眠质量的直接效应为-0.33(P<0.05);社交焦虑对睡眠质量的直接效应为-0.04(P>0.05),社交焦虑通过自尊对高血压患者睡眠质量的间接效应为0.13(P<0.05),自尊、社交焦虑共解释高血压患者睡眠质量9.80%的变异量。结论高血压患者社交焦虑通过自尊对睡眠质量起完全中介效应,护理人员应用合适的方式,鼓励患者参加社交活动,提高其自尊水平,以改善高血压患者的睡眠质量。

Objective To explore the effect of self-esteem on social anxiety and sleep quality of hypertensive patients,and to develop a structural equation model,and to provide reference for health interventions on hypertensive patients.Methods The cluster sampling design was used in this study,340 hypertensive patients hospitalized and got treatment in Yijishan hospital from July to October 2021 were enrolled as study objects.Self-Esteem Scale(SES),Social Phobia Inventory(SPIN)and Pittsburgh Sleep Quality Index(PSQI)scale were used to evaluate the self-esteem,social anxiety and sleep quality.SPSS 25.0 software was used to analyze data,and Amos 21.0 software was used to construct structural equation model.Results A total of 333 valid questionnaires were returned.Correlation analysis showed that there was a linear correlation between every two of sleep quality,self-esteem and social anxiety in hypertensive patients(P<0.05).Self-esteem was negatively correlated with social anxiety and sleep quality(r=-0.298,P<0.05;r=-0.305,P<0.05),and social anxiety was positively correlated with sleep quality(r=0.134,P<0.05).Multiple regression analysis showed that gender and self-esteem play a predictive effect on sleep quality of hypertensive patients,and could explain 10.90%of the variance of the sleep quality(P<0.05).Structural equation model showed that the direct effect of social anxiety on self-esteem was-0.40(P<0.05),which could explain 15.70%of the variance of the self-esteem.The direct effect of self-esteem on sleep quality was-0.33(P<0.05);the direct effect of social anxiety on sleep quality was-0.04(P>0.05),and the indirect effect of social anxiety through self-esteem on sleep quality was 0.13(P<0.05),and self-esteem and social anxiety could explain 9.80%of the variance of the sleep quality.Conclusions The self-esteem of hypertensive patients fully mediates the relationship between social anxiety and sleep quality.Nurses should apply appropriate methods to encourage patients to participate in social activities and increase their self-esteem level in order to improve sleep quality of hypertensive patients.