心理弹性在盆底功能障碍性疾病患者病耻感与生活质量间的中介效应研究

Mediating effect of psychological resilience between stigma and quality of life in patients with pelvic floor dysfunction

目的探讨盆底功能障碍性疾病(PFD)患者病耻感、心理弹性与生活质量的相关性,以及心理弹性在病耻感与生活质量间的中介效应。方法采用方便抽样法选择2021年11月至2022年3月在四川省绵阳市某3所三级甲等综合医院妇产科及盆底中心接受治疗的PFD患者229例作为研究对象。采用一般情况调查表、修订版社会影响量表(SIS)、心理弹性量表简表(CD-RISC-10)、盆底功能障碍问卷-20(PFDI-20)进行调查。采用Amos26.0软件分析心理弹性的中介效应。结果229例患者SIS总分(38.34±4.52)分,CD-RISC-10总分(28.17±5.76)分,PFDI-20总分(30.80±8.69)分。PFD患者SIS总分与PFDI-20总分呈正相关(r=0.666,P<0.05),与CD-RISC-10总分呈负相关(r=-0.642,P<0.05)。SIS总分可以对PFDI-20总分进行正向预测(β=0.533,P<0.001);SIS总分可以对CD-RISC-10得分进行负向预测(β=-0.593,P<0.001);心理弹性对生活质量具有预测作用(β=-0.338,P<0.001)。心理弹性在病耻感与生活质量间的直接效应为2.113,间接效应为1.271,总效应为3.384。结论PFD患者的症状对其生活质量影响较小,患者整体生活质量较好,心理弹性在病耻感与生活质量间具有部分中介作用。医务人员应重视患者的心理健康状况,采取相应的措施以提高患者的心理弹性水平,从而帮助患者减轻病耻感,改善其生活质量。

Objective To explore the correlation between stigma,psychological resilience and quality of life in patients with pelvic floor dysfunction(PFD),and the mediating effect of psychological resilience between stigma and quality of life.Methods A total of 229 patients with PFD treated in the department of obstetrics and gynecology and pelvic floor center of 3 grade A tertiary general hospitals in Mianyang City Sichuan Province from November 2021 to March 2022 were selected as the study objects by the handy sampling method.The questionnaire survey was conducted by using the general situation questionnaire,the revised social impact scale(SIS),the brief form of 10-item connor-davidson resilience scale(CD-RISC-10)and the pelvic floor dysfunction questionnaire-20.Amos 26.0 software was used to analyze the mediating effect of psychological resilience.Results In 229 patients,the total score of SIS was(38.34±4.52)points,CD-RISC-10 was(28.17±5.76)points,PFDI-20 was(30.80±8.69)points.The total score of SIS was positively correlated with PFDI-20 score(r=0.666,P<0.05),and negatively correlated with CD-RISC-10(r=-0.642,P<0.05).The total socre of SIS could positively predict PFDI-20 score(β=0.533,P<0.001).The total score of SIS could negatively predict CD-RISC-10 score(β=-0.593,P<0.001).The psychological resilience had a predictive effect on quality of life(β=-0.338,P<0.001).The direct effect of psychological resilience between stigma and quality of life was 2.113,the indirect effect was 1.271 and the total effect was 3.384.Conclusion The symptoms of PFD patients have little effect on their quality of life,and their overall quality of life is good,the psychological resilience has a partial mediating effect between stigma and quality of life.The medical staff should pay attention to the psychological health status of the patients,take corresponding measures to improve the level of patients′psychological resilience,so as to help patients reduce their stigma and improve their quality of life.