主动脉夹层患者及家属自我分化与焦虑抑郁关系的主客体互倚模型分析

Actor-partner independence model about relationship between differentiation of self,depression and anxiety in aortic disection patients and families

目的 基于鲍温家庭系统理论,使用主客体互倚模型探查主动脉夹层患者及家属焦虑、抑郁的交互传递情况。方法 采用一般调查问卷、简版自我分化量表、广泛焦虑性量表、患者健康问卷抑郁量表对210对主动脉夹层患者及家属进行调查,建立自我分化、焦虑及抑郁的主客体互倚模型。结果 主动脉夹层患者及家属的自我分化水平分别为(79.95±4.43)分和(81.31±4.55)分,焦虑程度分别为(11.74±3.55)分和(10.98±3.04)分,抑郁程度分别为(12.33±3.34)分和(10.98±3.04)分。主客体互倚模型结果显示,主动脉夹层患者的自我分化水平与自身及对方的焦虑、抑郁水平呈负相关,家属的自我分化水平与自身的焦虑、抑郁和患者的抑郁呈负相关(均P<0.05)。结论 主动脉夹层患者及家属的焦虑、抑郁受双方自我分化水平的共同影响,提示医护人员应重视主动脉夹层患者及家属焦虑、抑郁的传递情况,积极探索以家庭为单位的干预方案。

Objective To examine the intergenerational transmission of anxiety and depression in aortic dissection patients and their families,then using the Actor-Partner Interdependence model based on Bowen family systems theory.Methods A general questionnaire,a Brief differentiation of self Inventory-Revised,a 7-item Generalized Anxiety Disorder Scale,and a Patient Health Questionnaire-9 were used to investigate 210 pairs of aortic dissection patients and family members to develop an Actor-Partner Interdependence model about differentiation of self,anxiety and depression.Results Differentiation of self scores related to aortic dissection patients and family members were 79.95±4.43 and 81.31±4.55,anxiety scores were 11.74±3.55 and 10.98±3.04,and depression scores were 12.33±3.34 and 10.98±3.04,respectively.Anxiety scores of aortic dissection patients were significantly higher than those of their family members;the results of the Actor-Partner Interdependence model showed that the differentiation of self of aortic dissection patients was negatively correlated with their own,including anxiety and depression of their families.And the differentiation of self of family members was negatively correlated with their own anxiety and depression and the depression of patients.Conclusion The anxiety and depression of aortic dissection patients and family members were jointly influenced by the differentiation of self,suggesting that healthcare practioners should pay attention to the transmission of anxiety and depression in aortic dissection patients and family members to actively explore family-based intervention programmes.