灵性健康与负性情绪在血液透析患者社会支持与主观幸福感间的链式中介效应

The chain mediating effect of spiritual health and negative emotions between social support and subjective well-being in hemodialysis patients

目的了解维持性血液透析患者的主观幸福感水平,探讨社会支持、负性情绪、灵性健康与主观幸福感的关系。方法随机抽取2022年9月-2023年1月辽宁省2所三甲医院的344例维持性血液透析患者作为研究对象,采用一般资料调查表、社会支持量表、医院焦虑抑郁量表、慢性疾病治疗功能评估-灵性量表和主观幸福感量表进行横断面研究。使用AMOS 24.0软件,基于多重中介模型对路径进行分析。结果维持性血液透析患者社会支持总分为(30.26±7.07)分,负性情绪总分为(16.08±8.17)分,灵性健康总分为(30.89±6.92)分,主观幸福感得分为(64.51±9.51)分。构建链式中介模型,社会支持对主观幸福感的总间接效应为59.68%,其中链式中介作用占45.69%。结论维持性血液透析患者主观幸福感处在中等水平,负性情绪和灵性健康在社会支持和主观幸福感间产生链式中介效应。医护人员应当给予患者足够的理解与支持,减少其负面情绪,赋予患者抗击疾病的勇气和希望,提升主观幸福感。

Objective To understand the subjective well-being level of patients with maintenance hemodialysis,and explore the relationship between social support,negative emotions,spiritual health,and subjective well-being.Methods A total of 344 patients with maintenance hemodialysis in 2 tertiary hospitals in Liaoning province from September 2022 to January 2023 were randomly selected as the research objects.A cross-sectional study was conducted by using the general data questionnaire,Social Support Scale,Hospital Anxiety and Depression Scale,Chronic Disease Treatment Function Assessment-Spirituality Scale,and Subjective Well-Being Scale.The pathways were analyzed based on the multiple mediation model using AMOS 24.0 software.Results The total score of maintenance hemodialysis patients was(30.26±7.07)points for social support,(16.08±8.17)points for negative emotions,(30.89±6.92)points for spiritual health,and(64.51±9.51)points for subjective well-being.Constructing a chain mediation model,the total indirect effect of social support on subjective well-being was 59.68%,of which the chain mediation effect accounts for 45.69%.Conclusion The level of subjective well-being of maintenance hemodialysis patients is at a moderate level,and negative emotions and spiritual health have a chain mediating effect between social support and subjective well-being.Medical staff should give patients sufficient understanding and support,reduce their negative emotions,give patients courage and hope to fight the disease,and improve subjective well-being.