心理弹性在军人胫腓骨骨折自我应激和创伤后成长中的中介作用

Mediating roles of resilience in self-stress and post-traumatic growth among soldiers with tibial and fibula fractures

目的探讨胫腓骨骨折军人患者心理弹性与自我应激和创伤后成长的关系。方法选取联勤保障部队第九〇九医院2020年—2021年收治79例胫腓骨骨折军人患者为研究对象,采用心理弹性量表、心理应激量表和创伤后成长量表评估军人患者心理状况,分析相关性后,统计方法构建心理弹性、自我应激和创伤后成长模型,并分析心理弹性在心理应激和创伤后成长中的中介效应。结果军人心理应激量表评分与心理弹性量表评分、创伤后成长量表评分呈负相关(r=-0.647、-0.468,P<0.01、0.05)、心理弹性量表评分与创伤后成长量表评分呈正相关(r=0.674,P<0.01);中介效应检验显示,拟合优度指数为0.989、调整拟合优度指数为0.927、拟合指数为0.962、比较拟合指数为0.989,均>0.9,近似误差均方根为0.031;路径分析显示,心理应激直接作用于创伤后成长,也可以通过心理弹性作用于创伤后成长,中介效应为0.12,总效应为0.83。结论军人胫腓骨骨折创伤后成长与心理应激和心理弹性相关,心理应激程度可以直接影响创伤后成长水平,也可以通过心理弹性的中介效应发挥作用。

Objective To explore the relationships between mental resilience,self-stress and post-traumatic growth in soldiers with tibial and fibula fractures.Methods A total of 79 patients with tibial and fibula fractures admitted to the 909th Hospital of the Joint Logistic Support Force between 2020 and 2021 were selected as the subjects.The psychological status of these patients was assessed with the Psychological Resilience Scale,Military Psychological Stress Scale and Post-traumatic Growth Scale before the correlations were analyzed.A model of resilience,self-stress and post-traumatic growth was constructed,and the mediating effect of resilience on psychological stress and post-traumatic growth was analyzed.Results There was a negative correlation between the scores of the psychological stress scale and the scores of the psychological resilience scale and post-traumatic growth scale(r=-0.647,-0.468,P<0.01,0.05).The score of the psychological resilience scale was positively correlated with the score of the post-traumatic growth scale(r=0.674,P<0.01).The mediating effect test showed that the goodness of fit index(GFI)was 0.989,and the adjusted goodness of fit index(AGFI)was 0.927,the normed fit index(NFI)was 0.962,comparative fit index(CFI)was 0.989,and root mean square error of approximation(RMSEA)was 0.031.Pathway analysis showed that psychological stress directly acted on post-traumatic growth and could also act on post-traumatic growth through psychological resilience,with a mediating effect of 0.12 and a total effect of 0.83.Conclusion Post-traumatic growth of soldiers with tibial and fibula fractures is related to psychological stress and psychological resilience.The degree of psychological stress can directly affect the level of post-traumatic growth,and plays a role through the mediating effect of psychological resilience.