社会支持在HIV感染孕妇感知歧视与自杀意念关系的中介效应

The Mediating Effect of Social Support Between Perceived Discrimination and Suicidal Ideation in HIV-infected Pregnant Women

目的探讨社会支持在艾滋病病毒感染孕妇感知歧视与自杀意念关系的中介效应。方法采用随机整体抽样法选择152例HIV感染孕妇(HIV组)和201例正常妊娠孕妇(对照组),采用自行设计的一般调查问卷收集受试者一般社会人口学资料、社会支持评定量表(SSRS)、Berger HIV感知歧视量表(BHSS)、Beck自杀意念量表中文版(BSI-CV)测评患者社会支持、感知歧视、自杀意念。用Pearson相关分析探讨SSRS总分、BHSS总分、BSI-CV总分之间相关性,用线性回归检验社会支持在感知歧视和自杀意念之间的中介效应。结果HIV组孕妇BHSS、BSI-CV总分以及各个维度得分高于对照组(P<0.05),SSRS总分以及各个维度得分低于对照组(P<0.05)。自杀意念组SSRS总分以及各个维度得分低于无自杀意念组(P<0.05),BHSS总分以及各个维度得分高于无自杀意念组(P<0.05)。HIV感染孕妇SSRS总分与BHSS总分、最抑郁时BSI-CV总分呈高度负相关(P<0.05),BHSS总分与最抑郁时BSI-CV总分呈高度正相关(P<0.05)。线性回归分析结果显示,社会支持对感知歧视和自杀意念存在中介效应(β=-1.904,P<0.05)。结论社会支持在HIV感染孕妇感知歧视和自杀意念间起完全中介效应,对HIV感染孕妇应加强社会支持,以减弱感知歧视程度,降低自杀意念的发生率。

Objective To investigate the mediating effect of social support between perceived discrimination and suicidal ideation in HIV-infected pregnant women.Methods A total of 152 HIV-infected pregnant women(HIV group)and 201 normal pregnant women(control group)were selected by random sampling.A self-designed general questionnaire was used to collect general sociodemographic data of the subjects.Social support,perceived discrimination and suicidal ideation were assessed by social support rating scale(SSRS),Berger HIV stigma scale(BHSS)and Beck scale for suicide ideation-Chinese version(BSI-CV).Pearson correlation analysis was conducted to analyze the correlation between SSRS total scores,BHSS total scores and BSI-CV total scores,and linear regression was used to test the mediating effect of social support between perceived discrimination and suicidal ideation.Results The total score of BHSS,BSI-CV and scores of each dimension in HIV group were higher than those in control group(P<0.05),and the total score of SSRS and scores of each dimension were lower than those in control group(P<0.05).The total SSRS score and all dimensions scores of the suicidal ideation group were lower than those of the non-suicidal ideation group(P<0.05),and the total BHSS score and all dimensions scores of the suicidal ideation group were higher than those of the non-suicidal ideation group(P<0.05).The total SSRS score of HIV-infected pregnant women was highly negatively correlated with the total BHSS score and the total BSI-CV score at the most depressed(P<0.05),and the total BHSS score was highly positively correlated with the total BSI-CV score at the most depressed(P<0.05).The results of linear regression analysis showed that social support had a mediating effect between perceived discrimination and suicidal ideation(β=-1.904,P<0.05).Conclusion Social support is a complete mediator between perceived discrimination and suicidal ideation in HIV-infected pregnant women.Social support should be strengthened for HIV-infected pregnant women to reduce perceived discrimination and reduce the incidence of suicide ideation.