自我效能、相依关系在脑卒中患者照顾者照顾准备度与照顾压力间的链式中介作用

Chain mediating effect of self-efficacy and mutuality on preparedness and care stress of caregivers for stroke survivors

目的探讨自我效能、相依关系在脑卒中患者照顾者照顾准备度和照顾压力间的中介作用。方法采用方便抽样法,选取2022年6月-9月河南省某三级甲等综合医院神经内科收治的252例脑卒中患者的照顾者为研究对象,应用一般资料调查表、照顾者准备度量表、照顾者压力量表、相依关系量表及照顾者自我护理贡献自我效能量表对其进行问卷调查。结果脑卒中患者照顾者照顾压力得分为(9.12±2.13)分,相依关系得分为(39.08±2.96)分,照顾准备度得分为(20.59±2.12)分,自我效能得分为(74.53±5.25)分。照顾压力与照顾准备度、自我效能、相依关系均呈负相关(r=-0.655、-0.585、-0.548,均P<0.01),照顾准备度与自我效能、相依关系均呈正相关(r=0.750、0.631,均P<0.01)。照顾准备度可直接影响照顾压力,还可通过自我效能、相依关系及自我效能和相依关系的链式中介作用对照顾压力产生影响,其中介效应值分别为-0.092、-0.070、-0.039。结论自我效能和相依关系在脑卒中患者照顾者照顾准备度与照顾压力间起链式中介作用。医护人员应主动提供针对性教育和指导,促使照顾者积极适应角色变化,并增强其照顾信念,同时制定以相依关系为中心的干预措施,以期更加高效地减轻照顾者的照顾压力。

Objective To explore the mediating effect of self-efficacy and mutuality on preparedness and care stress of caregivers for stroke survivors.Methods The caregivers of 252 stroke survivors hospitalized in the neurology ward of a grade-A tertiary hospital in Henan province between June and September 2022 were selected using the convenient sampling method,and surveyed using the caregiver preparedness scale(CPS),caregiver strain index(CSI),mutuality scale(MS),and the caregiver self-efficacy in contributing to patient self-care scale(CSE-CSC).Results The score of CSI was(9.12±2.13)point,negatively correlated to the CPS,CSE-CSC and MS scores(20.59±2.12,74.53±5.25,39.08±2.96;r=-0.655,-0.585,-0.548,P<0.01 for all).Moreover,the CPS score was positively correlated to the CSE-CSC and MS scores(r=0.750,0.631,P<0.01 for both).Caregiver readiness had direct effect on their caregiving stress,or indirect effect through the self-efficacy,mutuality and their chain mediating effect,with the affecting values of-0.092,-0.070 and-0.039.Conclusion Self-efficacy and mutuality play a chain mediating role between caregiving readiness and caregiving stress.Therefore,medical staff should provide targeted education and guidance to help caregivers to adapt actively to their roles,and develop mutuality-centered intervention to reduce their stress efficiently.