知觉压力影响创伤康复期患者事件影响程度的中介效应路径分析

Path analysis of mediating effect of perceived stress affecting impact of event in rehabilitation patients with traumatic injury

目的探讨知觉压力对创伤康复期患者事件影响程度的影响,以及情绪调节困难、沉思和睡眠的中介作用。方法2022年3月至2023年3月,方便抽取西南医院、新桥医院和大坪医院创伤康复期患者192例进行问卷调查。评估工具包括知觉压力量表、中文版情绪调节困难问卷、简版沉思反应量表、睡眠状况自评量表和事件影响量表修订版。结果创伤康复期患者的知觉压力、情绪调节困难、沉思、睡眠和事件影响程度两两呈正相关(r=0.447~0.684,P<0.01)。知觉压力显著正向预测事件影响程度(β=0.49,P<0.001),以及情绪调节困难(β=0.70,P<0.001)、沉思(β=0.21,P<0.05)和睡眠(β=0.29,P<0.001)。知觉压力对事件影响程度的直接效应不显著,但可通过7条间接效应路径影响事件影响程度,其中情绪调节困难、沉思和睡眠的单一中介效应占比分别为24.41%、11.91%和24.82%,情绪调节困难和沉思的链式中介效应占比13.88%,情绪调节困难和睡眠的链式中介效应占比18.08%,沉思和睡眠的链式中介效应占比3.17%,情绪调节困难、沉思和睡眠的链式中介效应占比3.70%。结论知觉压力通过情绪调节困难、沉思和睡眠的单一中介作用和链式中介作用影响创伤康复期患者的事件影响程度。

Objective To explore the effect of perceived stress on the impact of event in rehabilitation patients with traumatic injury,and the mediating role of difficulties in emotion regulation,rumination and sleep.Methods From March,2022 to March,2023,using the convenient sampling method,a questionnaire survey was conducted on 192 rehabilitation patients with traumatic injury from Southwest Hospital,Xinqiao Hospital and Daping Hospital.Assessment tools included Perceived Stress Scale,Difficulties in Emotion Regulation Scale,Brief Ruminative Response Scale,Self-Rating Scale of Sleep,and Impact of Event Scale-revised.Results Perceived stress,difficulties in emotion regulation,rumination,sleep and the impact of event were correlated with each other in rehabilitation patients with traumatic injury(r=0.447~0.684,P<0.01).Perceived stress significant positively predicted the impact of event(β=0.49,P<0.001),as well as difficulties in emotion(β=0.70,P<0.001),rumination(β=0.21,P<0.05)and sleep(β=0.29,P<0.001).The direct effect of perceived stress on the impact of event was not significant,but it affected the impact of event through seven mediation paths,among which the independent mediation effect size of difficulties in emotion regulation,rumination and sleep accounted for 24.41%,11.91%and 24.82%,respectively;the chain mediation effect size of difficulties in emotion regulation and rumination accounted for 13.88%,the chain mediation effect size of difficulties in emotion regulation and sleep accounted for 18.08%,the chain mediation effect size of rumination and sleep accounted for 3.17%,and the chain mediation effect size of difficulties in emotion regulation,meditation and sleep accounted for 3.70%.Conclusion Perceived stress affected the impact of event in rehabilitation patients with traumatic injury through the independent mediation and chain mediation of difficulties in emotion regulation,rumination and sleep.