疾病感知在植物持续状态或微小意识状态患者主要照顾者感知负担与生活质量间的中介效应

Mediating effect of illness perception between perceived burden and quality of life of primary caregivers of patients with persistent vegetative state or minimally conscious state

目的:探讨疾病感知在植物持续状态或微小意识状态患者主要照顾者感知负担与生活质量间的作用机制,为提高其主要照顾者生活质量提供参考依据。方法:本研究为横断面研究。采用便利抽样法,选取2021年8月-2022年1月入住合肥市第二人民医院高压氧病区的160例植物状态或微小意识状态患者的主要照顾者为研究对象,应用一般资料调查表、照顾者感知负担问卷、照顾者疾病感知问卷、照顾者生活质量问卷进行调查。采用Pearson相关性分析植物持续状态或微小意识状态患者主要照顾者疾病感知、感知负担、生活质量的相关性。采用逐步回归分析疾病感知的中介作用,并采用AMOS 23.0构建结构方程模型并进行验证。结果:本研究中植物持续状态或微小意识状态患者主要照顾者的疾病感知得分为(60.54±9.48)分,感知负担得分为(32.08±5.83)分,生活质量得分为(7.83±2.31)分。主要照顾者疾病感知总分与生活质量总分呈正相关( r=0.597, P<0.01),生活质量总分与感知负担总分呈负相关( r=-0.630, P<0.01),感知负担总分与疾病感知总分呈负相关( r=-0.623, P<0.01)。疾病感知在植物持续状态或微小意识状态患者主要照顾者感知负担与生活质量间起部分中介效应,中介效应占总效应值的20.22%。 结论:照顾者感知负担可以直接预测生活质量,也可以通过疾病感知间接作用于生活质量。降低主要照顾者疾病感知水平,有利于降低疾病感知负担,改善其生活质量,提高照护水平。

Objective To explore the mechanism of illness perception between the perceived burden and quality of life of the primary caregivers of patients with persistent vegetative state or minimally conscious state,so as to provide reference for improving the quality of life of primary caregivers.Methods This study was a cross-sectional study.From August 2021 to January 2022,the primary caregivers of 160 patients with persistent vegetative state or minimally conscious state in the Hyperbaric Oxygen Ward of the Second People's Hospital of Hefei were selected as the research object by the convenience sampling.The General Information Questionnaire,Perceived Caregiver Burden Scale for Caregivers,Brief Illness Perception Questionnaire,and the CarerQol Instrument were used for investigation.Pearson correlation was used to analyze the correlation of illness perception,perceived burden,and quality of life of the primary caregivers of patients with persistent vegetative status or minimally conscious state.Stepwise regression was used to analyze the mediating effect of illness perception,and structural equation model was constructed and verified using AMOS23.0.Results The scores of illness perception,perceived burden and quality of life of the primary caregivers of patients with persistent vegetative state or minimally conscious state were(60.54±9.48),(32.08±5.83)and(7.83±2.31)respectively.The total score of illness perception was positively correlated with the total score of quality of life(r=0.597,P<0.01),the total score of quality of life was negatively correlated with the total score of perceived burden(r=-0.630,P<0.01),and the total score of perceived burden was negatively correlated with the total score of illness perception(r=-0.623,P<0.01).Illness perception played a part of mediating effect between the perceived burden and quality of life of the primary caregivers of patients with persistent vegetative state or minimally conscious state,and the mediating effect accounted for 20.22%of the total effect value.Conclusions The perceived burden of caregivers can directly predict the quality of life,and can also indirectly affect the quality of life through illness perception.Reducing the illness perception level of the primary caregivers is conducive to decreasing the illness perception burden,improving their quality of life and the level of care.