自尊在青少年牙槽突裂患者社会支持和心理韧性间的中介作用

Mediating effects of self-esteem between social support and psychological resilience in adolescent patients with alveolar cleft

目的调查青少年牙槽突裂患者社会支持、心理韧性及自尊情况,探讨社会支持与心理韧性之间的关系,以及自尊在社会支持与心理韧性的中介作用,为综合序列治疗中的心理支持提供理论依据。方法采用方便抽样法,对161例牙槽突裂青少年患者采用由一般资料、自尊量表、青少年社会支持量表和青少年心理韧性量表组成的问卷进行调查,运用Pearson相关分析法探讨社会支持、心理韧性和自尊的相关性,采用Process宏程序的Bootstrap进行中介效应分析和检验。结果青少年牙槽突裂患者的社会支持、心理韧性、自尊得分分别为(74.54±10.02)、(102.03±15.09)和(31.32±5.17)分,处于中等水平。心理韧性得分在不同年龄、居住地及家庭收入人群中有明显差异(P<0.05)。社会支持量表得分和自尊量表得分均与心理韧性得分呈正相关关系(r=0.67、0.63,P<0.01),社会支持与自尊也呈正相关(r=0.37,P<0.01)。社会支持对心理韧性存在直接效应(β=0.735,95%CI:0.575~0.910),并通过自尊的部分中介效应而间接影响心理韧性(β=0.242,95%CI:0.143~0.360),中介效应占总效应的24.78%。结论自尊在青少年牙槽突裂患者社会支持和心理韧性间发挥中介效应,患者的心理韧性水平随自尊和社会支持水平而提高。患者年龄、居住地及家庭收入均是心理韧性的影响因素。医护人员、患儿家属和社会机构应多渠道共同提高患者的自尊水平,从而提高其心理韧性水平,为序列治疗的有效开展提供保障。

Objective To investigate the current status of social support,mental toughness and self-esteem in adolescent patients with alveolar cleft,to explore the relationship between social support and mental toughness and the mediating role of self-esteem in social support and mental toughness,and ultimately to provide a theoretical basis for psychological support in comprehensive sequential therapy.Methods A series of questionnaires consisting of general information,Self-esteem Scale,Child and Adolescent Social Support Scale,and Resilience Scale for Chinese Adolescent were used to investigate 161 adolescent patients with alveolar cleft in a tertiary care hospital in Shanghai using convenience sampling method.Pearson correlation analysis was used to explore the correlation between social support,mental toughness and self-esteem;Bootstrap with Process macro program was used to analyze and verify the mediation effect.Results The social support,mental toughness,and selfesteem scores of adolescent patients with alveolar cleft were 74.54±10.02,102.03±15.09,and 31.32±5.17 respectively,which were at an intermediate level.Mental toughness scores were statistically different among different ages,places of residence and household income levels(P<0.05).Both social support and self-esteem scores were positively correlated with mental toughness score(r=0.67,0.63,both P<0.01),and social support was also positively correlated with self-esteem(r=0.37,P<0.01).Social support directly affected mental toughness(β=0.735,95%CI:0.575-0.910),and indirectly affected mental toughness through a partial mediating effect of self-esteem(β=0.242,95%CI:0.143-0.360),with the mediating effect accounting for 24.78%of the total effect.Conclusion Self-esteem has a mediating effect between social support and mental toughness in adolescent patients with alveolar cleft,and patients’mental toughness level increases with the increase of self-esteem and social support levels.The patients’age,residence and family income were all influencing factors of mental toughness.Therefore,medical and nursing staff,family members of patients,and social institutions should work together to improve the patient’s self-esteem level,thereby increasing his or her mental toughness level and providing security for the effective implementation of sequence therapy.