下肢深静脉血栓患者疾病不确定感及应对方式对自我感受负担影响的路径分析

Path analysis of the influence of disease uncertainty and coping style on self-perceived burden in patients with lower extremity deep vein thrombosis

目的 探讨下肢深静脉血栓(DVT)患者疾病不确定感、应对方式、自我感受负担(SPB)三者之间的关系。方法 采用便利抽样法, 选取2020年9月-2021年4月在沧州市3所三级甲等医院血管外科住院治疗的280例下肢DVT患者为研究对象, 采用一般资料调查问卷、SPB量表、医学应对方式问卷和疾病不确定感量表对患者进行调查。采用Pearson相关分析变量间的相关性。本研究共发放280份问卷, 回收有效问卷262份, 有效回收率为93.6%。结果 262例下肢DVT患者SPB得分为(28.83±7.43)分;疾病不确定感、回避、屈服与患者SPB呈正相关(r值分别为0.651、0.477、0.469;P<0.01), 面对与SPB呈负相关(r=-0.485, P<0.01)。路径分析结果显示, 回避、屈服在疾病不确定感与SPB间发挥部分中介效应, 占路径总效应量的14.6%。结论 疾病不确定感可以通过回避、屈服间接影响下肢DVT患者SPB, 临床医护人员应针对性制订干预和健康指导策略, 改善患者疾病认知和应对能力, 降低患者SPB水平。

Objective To explore the relationship between disease uncertainty,coping style,and self-perceived burden(SPB)in patients with lower extremity deep vein thrombosis(DVT).Methods Totally 280 patients with lower extremity DVT who were hospitalized in the Department of Vascular Surgery of three ClassⅢGrade A hospitals in Cangzhou from September 2020 to April 2021 were selected by convenience sampling and investigated with the general information questionnaire,Medical Coping Style Questionnaire,Self-Perceived Burden Scale(SPBS),Medical Coping Modes Questionnaire(MCMQ),and Mishel's Uncertainty in Illness Scale(MUIS-A).Pearson correlation was used to analyze the correlation between variables.A total of 280 questionnaires were distributed in this study,and 262 valid questionnaires were recovered,with an effective recovery rate of 93.6%.Results The SPB score of the 262 patients with lower extremity DVT was(28.83±7.43);disease uncertainty,avoidance,and yielding were positively correlated with the patients'SPB(r=0.651,0.477,0.469;P<0.01),while facing was negatively correlated with SPB(r=-0.485,P<0.01).The path analysis revealed that avoidance and yielding played a partial mediating effect between disease uncertainty and SPB,accounting for 14.6%of the total path effect.Conclusions Disease uncertainty can indirectly affect SPB in patients with lower extremity DVT through avoidance and yielding.Clinical medical staff should formulate targeted intervention and health guidance strategies to improve patients'disease cognition and coping ability,and reduce their SPB.