自动思维在慢性肾脏病患者恐惧疾病进展和生活质量间的中介效应

Mediating effect of automatic thoughts on the relationship between feaRof disease progression and quality of life in patients with chronic kidney disease

目的探讨自动思维在慢性肾脏病患恐惧疾病进展和生活质量之间的中介调节作用。方法采用简化恐惧疾病进展量表、SF-36健康调查量表、自动思维问卷对合肥第三人民医院收治的120例慢性肾脏病患者进行调查,通过建立结构方程模型评价自动思维在恐惧疾病进展和生活质量中的中介效应。结果慢性肾脏病患者恐惧疾病进展得分为(29.20±7.93)分,生活质量得分为(435.72±32.06)分,自动思维得分为(49.27±10.67)分。CKD患者自动思维与年龄、家庭人均月收入、文化程度、CKD分期有关(P<0.05),恐惧疾病进展和生活质量与家庭人均月收入、CKD分期有关(P<0.05)。生活质量与恐惧疾病进展和自动思维得分呈负相关(P<0.05),恐惧疾病进展与自我思维得分呈正相关(P<0.05)。自动思维在恐惧疾病进展和生活质量间存在中介调节作用,中介效应值为-0.07,中介效应占总效应的11.1%。结论自动思维在慢性肾脏病患者恐惧疾病进展和生活质量间存在中介效应,医护人员应积极开展以降低负性自动思维为目标的干预策略,以达到提高患者生活质量的目的。

Objective To investigate the mediating effect of automatic thoughts on the relationship between feaRof disease progression and quality of life in patients with chronic kidney disease(CKD).Methods A total of 120 CKD patients treated with the Third People’s Hospital of Hefei were investigated by the FeaRof Progression Questionnaire-Short Form(FoP-Q-SF),the MOS 36-item Short Form Health Survey(SF-36),and the Automatic Thoughts Questionnaire(ATQ).A structural equation model was established to evaluate the mediating effect of automatic thoughts on the relationship between feaRof disease progression and quality of life.Results The scores of FoP-Q-SF,SF-36 and ATQ in CKD patients were(29.20±7.93),(435.72±32.06),and(49.27±10.67)points,respectively.Automatic thoughts were significantly correlated with the age,average monthly family income,education level and CKD stage(P<0.05).The feaRof disease progression and quality of life were significantly correlated with the average monthly family income and CKD stage(P<0.05).The quality of life was negatively correlated with the progression of feaRdisease and automatic thoughts(P<0.05),while the progression of feaRdisease was positively correlated with automatic thoughts(P<0.05).Automatic thoughts had a mediating effect between feaRof disease progression and quality of life.The mediating effect value was-0.07,accounting foR11.1%of the total effect.Conclusion Automatic thoughts play a mediating effect on the relationship between feaRof progression and quality of life in CKD patients.Interventions to reduce negative automatic thoughts should be actively performed to CKD patients to enhance the quality of life.