疾病不确定感在原发性肾病综合征患儿照顾者照顾负担与照顾能力间的中介效应

The mediating effect of illness uncertainty between the care burden and care ability of caregivers of children with primary nephrotic syndrome

目的探讨疾病不确定感在原发性肾病综合征(PNS)患儿照顾者照顾负担与照顾能力间的中介效应。方法采用便利抽样的方法选取2022年12月至2023年5月新疆乌鲁木齐市3所三级甲等医院收治的符合纳入及排除标准的232例PNS患儿照顾者作为研究对象。采用Zarit负担量表、中文版疾病不确定量表、家庭照顾者照顾能力量表对其进行调查,采用AMOS 26.0构建结构方程模型,并进行中介效应检验。结果PNS患儿照顾者照顾负担总分为(29.09±8.49)分,疾病不确定感总分为(81.28±8.91)分,照顾能力总分为(34.24±4.07)分。中介效应分析结果显示,照顾负担和疾病不确定感对照顾能力有正向预测作用(β=0.227、0.485,P=0.001、<0.001)。疾病不确定感在照顾负担与照顾能力间起部分中介作用,中介效应占比为46.34%。结论疾病不确定感在PNS患儿照顾者照顾负担与照顾能力间起部分中介作用。建议医务人员采取有效措施降低照顾者照顾负担,减轻其疾病不确定感,进而提升照顾者照顾能力。

Objective To explore the mediating effect of illness uncertainty between the care burden and care ability of caregivers of children with primary nephrotic syndrome(PNS).Methods From December 2022 to May 2023,convenience sampling was used to select 232 caregivers of children with PNS who met the inclusion and exclusion criteria in ClassⅢGrade A hospitals in Urumqi,Xinjiang as the research objects.All of the patients were investigated with the Zarit burden interview,parents'perception of uncertainty scale and the family caregiver task inventory.AMOS 26.0 was used to construct the structural equation model,and the mediating effect was tested.Results The total score of care burden of children with PNS was(29.09±8.49),the total score of illness uncertainty was(81.28±8.91),and the total score of care ability was(34.24±4.07).The results of mediating effect analysis showed that care burden and illness uncertainty had positive predictive effects on care ability(β=0.227,0.485;P=0.001,<0.001).Illness uncertainty played a partial mediating role between the care burden and care ability,accounting for 46.34%of the mediating effect.Conclusion Illnesss uncertainty plays a partial mediating role between care burden and care ability of caregivers of children with PNS.It is recommended that medical staff take effective measures to reduce the care burden and illness uncertainty of caregivers,so as to improve the care ability of caregivers.