社会支持在中青年腹膜透析患者成人依恋和家庭抗逆力间的中介效应

The mediating effect of social support between adult attachment and family resilience in young and middle-aged patients undergoing peritoneal dialysis

目的探讨社会支持在中青年腹膜透析患者成人依恋和家庭抗逆力间的中介调节作用,旨在为中青年腹膜透析患者心理健康护理提供参考。方法 2019年9月至2022年2月,采用前瞻性研究方法,对湖南省人民医院进行腹膜透析的100例中青年患者进行调查,调查表包括一般资料调查表、亲密关系经历量表简版、社会支持量表、家庭抗逆力评定量表。通过多元线性回归和结构方程模型评价社会支持在成人依恋和家庭抗逆力间的中介作用。结果中青年腹膜透析患者亲密关系经历量表简版中依恋焦虑和依恋回避得分分别为(46.47 ± 10.23)分和(63.67 ± 10.37)分,社会支持量表得分为(36.40 ± 7.27)分,家庭抗逆力评定量表得分为(94.21 ± 11.40)分。依恋焦虑、依恋回避与社会支持量表总分及各维度得分、家庭抗逆力总分及各维度得分均呈负相关(r值为-0.844~-0.373,均P<0.05)。依恋焦虑和依恋回避通过社会支持对中青年腹膜透析患者家庭抗逆力的间接效应明显,社会支持的间接效用分别占总效应的41.6%和48.8%。结论社会支持在中青年腹膜透析患者成人依恋和家庭抗逆力中起中介作用,护理人员应以社会支持为切入点,减少成人依恋对家庭抗逆力带来的不良影响。

Objective To explore the mediating effect of social support between adult attachment and family resilience in young and middle-aged patients undergoing peritoneal dialysis,and to provide reference for psychological health care of young and middle-aged peritoneal dialysis patients.Methods From September 2019 to February 2022,the prospective research method was adopted to investigate a total of 100 young and middle-aged patients undergoing peritoneal dialysis by general information questionnaire,Experiences in Close Relationship Scale-short form,Social Support Rating Scale,Family Resilience Scale,respectively.Multiple linear regression and structural equation model was used to evaluate the mediating effect of social support on adult attachment and family resilience.Results The scores of attachment avoidance and attachment anxiety in Experiences in Close Relationship Scale-short form were(46.47±10.23)points and(63.67±10.37)points;Social Support Rating Scale scores were(36.40±7.27)points;Family Resilience Scale scores were(94.21±11.40)points.There was a negative correlation of attachment anxiety and attachment avoidance with total score and each dimension score of Social Support Rating Scale and total score and each dimension score of Family Resilience Scale(r values were-0.844--0.373,all P<0.05).Attachment anxiety and attachment avoidance had a significantly indirect effect on the family resilience of young and middle-aged peritoneal dialysis patients through social support,which showed that the mediating effect of social support accounts for 41.6%and 48.8%of the total effect.Conclusions Social support plays a mediating role in the relationship between adult attachment and family resilience in young and middle-aged peritoneal dialysis patients,nurses can focus on social support to reduce the adverse effects of adult attachment on family resilience.