基本心理需要满足对个人社会资本与维持性血液透析老年患者心理弹性的中介效应

The mediating effect of basic psychological needs satisfaction on personal social capital and psychological resilience in elderly patients on maintenance hemodialysis

目的:了解维持性血液透析老年患者心理弹性的现状及影响因素,探究基本心理需要满足对个人社会资本与心理弹性的中介效应。方法:采用随机抽样法,在2021年7至12月使用一般资料调查问卷、个人社会资本问卷、基本心理需要满足量表中文版、心理弹性量表对湖南省623例维持性血液透析老年患者进行调查。采用SPSS 28.0对数据进行分析。结果:维持性血液透析老年患者心理弹性得分为(23.242±8.186)分。分层回归分析显示,相较于60~69岁,≥80岁是维持性血液透析老年患者心理弹性的危险因素(β=-2.408,P=0.020);相较于小学及以下,高中及以上文化程度是维持性血液透析老年患者心理弹性的保护因素(β=1.860,P=0.013);个人社会资本和基本心理需要满足均对维持性血液透析老年患者心理弹性具有正向预测作用(β=0.087、4.216,P<0.001)。中介效应分析显示,个人社会资本不仅能够直接影响维持性血液透析老年患者心理弹性,还能通过基本心理需要满足间接影响心理弹性,其中自主性、信任感和关系性分别占效应值的10.5%、28.2%和8.3%。结论:维持性血液透析老年患者心理弹性处于较低的水平,需要着重关注高龄和低教育水平维持性血液透析老年患者。未来可以通过增加个人社会资本进而提高基本心理需要满足强化维持性血液透析老年患者心理弹性水平。

Objective:To understand the current situation and influencing factors of psychological resilience of elderly patients on maintenance hemodialysis,and to explore the mediating effect of basic psychological needs satisfaction on personal social capital and psychological resilience.Methods:Using a random sampling method,623 elderly patients on maintenance hemodialysis in Hunan Province were surveyed from July to December 2021 using the General Information Questionnaire,the Personal Social Capital Questionnaire,the Chinese version of the Basic Psychological Needs Satisfaction Scale,and the Psychological Resilience Scale.SPSS 28.0 was used to analyze the data.Results:Maintenance hemodialysis elderly patients'psychological resilience score were(23.242±8.186)points.Stratified regression analysis showed that≥80 years of age was a risk factor for psychological resilience in elderly patients on maintenance hemodialysis compared to 60-69 years of age(β=-2.408,P=0.020);high school and above education degree was a protective factor for psychological resilience in elderly patients on maintenance hemodialysis compared to elementary school and below(β=1.860,P=0.013);and both personal social capital and basic psychological needs satisfaction were positive predictors of psychological resilience in elderly patients on maintenance hemodialysis(β=0.087,4.216;P<0.001).Mediated effect analysis showed that personal social capital not only directly influenced psychological resilience in elderly patients on maintenance hemodialysis,but also indirectly influenced psychological resilience through basic psychological needs satisfaction with autonomy,competence and relatedness accounting for 10.5%,28.2% and 8.3% of the effect values,respectively.Conclusion:The psychological resilience of the elderly patients on maintenance hemodialysis showed a low level,and it is necessary to focus on the elderly patients on maintenance hemodialysis with high age and low education degree.In the future,the psychological resilience of maintenance hemodialysis elderly patients can be strengthened by increasing personal social capital and thus improving basic psychological needs satisfaction.