配偶夫妻疾病沟通与肠造口患者感知社会约束的交叉滞后模型

A cross-lagged model of spouse′s couple disease communication and perceived social constraints in patients with enterostomy

目的了解配偶夫妻疾病沟通与肠造口患者感知社会约束在患者出院后6个月内的变化趋势,并分析二者间的因果关系,为基于夫妻二元沟通视角的肠造口患者心理干预提供参考。方法使用一般资料调查表、社会约束量表、夫妻癌症相关沟通问题量表对206例肠造口患者及其配偶于出院后1个月、3个月、6个月进行调查。结果出院后6个月内,肠造口患者感知社会约束及配偶夫妻疾病沟通呈改善趋势(均P<0.05)。交叉滞后模型显示,出院后1个月配偶夫妻疾病沟通能够影响出院后3个月患者感知社会约束(β=0.254,P<0.05),出院后3个月配偶夫妻疾病沟通亦能够影响出院后6个月患者感知社会约束(β=0.153,P<0.05),而肠造口患者感知社会约束对配偶夫妻疾病沟通无预测作用(均P>0.05)。结论肠造口患者感知社会约束及配偶夫妻疾病沟通在出院后逐渐改善,配偶夫妻疾病沟通能够预测患者感知社会约束。医护人员应及时评估患者与配偶的沟通状态,促进患者配偶与患者的良性沟通,以缓解患者感知的社会约束。

Objective To investigate the trend of changes in spouse′s couple disease communication and enterostomy patients′perceived social constraints within sixth months after discharge,and to analyze the causal relationship between these two variables.Methods A total of 206 enterostomy patients and their spouses were investigated with the general information questionnaire,Social Constraints Scale,and Cancer-related Communication Problems within Couples Scale at 1 month,3 months and 6 months after discharge.Results Within 6 months after discharge,the perceived social constraints of patients with enterostomy and their spouse′s couple disease communication showed an improvement trend(both P<0.05).The cross-lag model revealed that the spouse′s couple disease communication at 1 month after discharge could affect the patients′perceived social constraints at 3 months after discharge(β=0.254,P<0.05),and the spouse′s couple disease communication at 3 months after discharge could also affect the patients′perceived social constraints at 6 months after discharge(β=0.153,P<0.05).However,the enterostomy patients′perceived social constraints had no predictive effect on spouse′s couple disease communication(all P>0.05).Conclusion The perceived social constraints of patients with enterostomy and their spouse′s couple disease communication gradually improve after discharge,and spouse′s couple disease communication can predict patients′perceived social constraints.Medical staff should timely assess the communication status between patients and their spouses and promote healthy communication between them so as to alleviate patients′perceived social constraints.