克罗恩病患者的抗逆力水平及影响因素分析

Analysis of resilience level and influencing factors in patients with Crohn′s disease

目的研究克罗恩病(CD)患者抗逆力水平及其影响因素。方法采用横断面调查研究方法。采用便利抽样法抽取2021年11月至2022年7月上海交通大学医学院附属瑞金医院收治的CD患者,发放电子问卷进行调查。问卷内容包括一般情况、抗逆力量表、简易应对方式量表、一般自我效能感量表、情绪调节量表、家庭关怀指数量表和领悟社会支持量表。通过单因素分析、Pearson相关分析和多元线性逐步回归分析方法,探讨CD患者抗逆力的影响因素。结果共收到有效问卷155份。155例CD患者中,男性92例(59.4%),女性63例(40.6%);年龄(36.82±12.22)岁;病程4.5(2.0,10.0)年;克罗恩病活动指数为70.25(30.12,115.19)分;曾接受肠道手术38例(24.5%);抗逆力总分(64.25±15.12)分,处于中等水平。单因素分析发现,不同性别、工作情况、医疗保障形式以及是否曾接受肠道手术的患者间抗逆力总分差异均具有统计学意义(均P<0.05)。不同文化程度和家庭月收入的患者间抗逆力乐观性维度差异均具有统计学意义(均P<0.05)。相关性分析发现,CD患者抗逆力与自我效能(r=0.715,P<0.01)、应对方式中的积极应对(r=0.553,P<0.01)和消极应对(r=0.172,P=0.033)呈正相关,与领悟社会支持中的家庭支持(r=0.448,P<0.01)、朋友支持(r=0.434,P<0.01)和其他支持(r=0.478,P<0.01)呈正相关,与情绪调节中的表达抑制(r=0.431,P<0.01)和重新评价(r=0.606,P<0.01)呈正相关。多元线性逐步回归分析发现,自我效能、积极应对、消极应对、性别、是否曾接受肠道手术、家庭月收入等为CD患者抗逆力的独立影响因素(均P<0.05),且影响依次降低。结论自我效能感高、多积极应对、少消极应对、家庭月收入高、曾经接受肠道手术及男性CD患者的抗逆力水平可能更高,其中自我效能感对抗逆力的影响最大。

Objective To study the level of resilience and influencing factors in patients with Crohn′s disease(CD).Methods A cross-sectional survey was conducted.The convenience sampling method was used to select CD patients admitted to Ruijin Hospital of Shanghai Jiao Tong University School of Medicine from November 2021 to July 2022.An electronic questionnaire was distributed for investigation,including general information,Connor-Davidson resilience scale,simplified coping style scale,general self-efficacy scale,emotion regulation questionnaire,family care index scale and perceived social support scale.The influencing factors of resilience in CD patients were analyzed through univariate analysis,Pearson correlation analysis,and multiple linear stepwise regression analysis.Results A total of 155 valid questionnaires were collected.Among the 155 CD patients,there were 92 males(59.4%)and 63 females(40.6%).The average age was(36.82±12.22)years,with a disease duration of 4.5(2.0,10.0)years.The Crohn′s disease activity index score was 70.25(30.12,115.19)points,and 38 patients(24.5%)had undergone intestinal surgery.The total score of resilience was(64.25±15.12)points and at a moderate level.Univariate analysis showed that there were significant differences in resilience among CD patients with different genders,employment statuses,medical insurance forms,and whether they had undergone intestinal surgery(all P<0.05).And there were significant differences in the optimism dimension of resilience among CD patients with different education levels and monthly household incomes(all P<0.05).Correlation analysis found that resilience in CD patients was positively correlated with self-efficacy(r=0.715,P<0.01),positive coping(r=0.553,P<0.01)and negative coping(r=0.172,P=0.033)in coping styles,family support(r=0.448,P<0.01),friend support(r=0.434,P<0.01),and other support(r=0.478,P<0.01)in perceived social support,and expression suppression(r=0.431,P<0.01)and reappraisal(r=0.606,P<0.01)in emotion regulation.Multiple linear stepwise regression analysis revealed that self-efficacy,positive coping,negative coping,gender,whether they had undergone intestinal surgery,and monthly household income were independent influencing factors for resilience in CD patients(all P<0.05),and the influence decreased in sequence.Conclusions The CD patients with high self-efficacy,more positive coping,less negative coping,high monthly household income,history of intestinal surgery,and being male may have higher level of resilience.And self-efficacy has the greatest impact.