ICU转出患儿自我表露对抑郁的影响:正念与接纳的链式中介作用

The effect of self-disclosure on depression in children discharged from the ICU:the chain mediating effect of mindfulness and acceptance

目的调查并分析ICU转出患儿自我表露对抑郁的影响,以及正念与接纳的链式中介作用。方法采用横断面调查,方便抽样选取2021年5月至2022年12月于浙江省某三级甲等儿童医院ICU转出的352例患儿为研究对象,采用一般资料调查表、痛苦表露指数量表、正念注意觉知量表、接纳与行动问卷第二版、流调中心抑郁量表进行调查,使用Pearson相关分析和回归分析对自我表露、正念、接纳、抑郁进行分析,并建立路径关系模型。结果患儿痛苦表露指数量表得分(36.43±6.26)分,正念注意觉知量表得分(47.82±8.29)分,接纳与行动问卷得分(24.27±4.32)分,抑郁量表得分(17.54±8.39)分。相关分析结果显示,自我表露与接纳、抑郁呈负相关(P<0.05),自我表露与正念呈正相关(P<0.05)。自我表露可负向预测抑郁(β=-0.138,P<0.001);正念在自我表露与抑郁间起中介作用,中介效应占比32.37%;接纳在自我表露与抑郁间起中介作用,中介效应占比18.59%;正念和接纳在自我表露与抑郁间起链式中介作用,中介效应占比4.81%。结论自我表露可直接影响ICU转出患儿抑郁情况,正念与接纳在自我表露与抑郁间起链式中介作用。

Objective To investigate and analyze the influence of self-disclosure on depression in children discharged from the ICU,and the chain mediating effect of mindfulness and acceptance.Methods A cross-sectional survey was conducted using a convenience sampling method to select 352 cases of children discharged from the ICU of a tertiary-level children's hospital in Zhejiang Province from May 2021 to December 2022 as the research subjects.The General Information Investigation Form,the Distress Disclosure Index(DDI),the Mindful Attention Awareness Scale(MAAS),the Acceptance and Action Questionnaire-Ⅱ(AAQ-Ⅱ),and the Center for Epidemiological Studies-Depression(CES-D)were used to investigate the subjects.Pearson correlation analysis and regression analysis were used to analyze self-disclosure,mindfulness,acceptance and depression,and a path model was established.Results The score of DDI was(36.43±6.26),the score of MASS was(47.82±8.29),the score of AAQ-Ⅱ was(24.27±4.32),and the score of CES-D was(17.54±8.39).The correlation analysis results showed that self-disclosure was negatively correlated with acceptance and depression(P<0.05),and positively correlated with mindfulness(P<0.05).Self-disclosure negatively predicted depression(β=-0.138,P<0.001);mindfulness played a mediating role in the relationship between self-disclosure and depression,with a mediating effect accounting for 32.37%;acceptance played a mediating role in the relationship between self-disclosure and depression,with a mediating effect accounting for 18.59%;mindfulness and acceptance played a chain mediating role in the relationship between self-disclosure and depression,with a mediating effect accounting for 4.81%.Conclusion Self-disclosure can directly affect the depressive condition of children discharged from the ICU,while mindfulness and acceptance serve as a chain mediator between self-disclosure and depression.