老年脑卒中患者心理弹性和应对方式在社会支持与心理痛苦间的链式中介作用

Chain mediation of psychological resilience and coping styles between social support and psychological distressinelderlystrokepatients

目的探讨心理弹性和应对方式在老年脑卒中患者社会支持与心理痛苦间的链式中介作用。方法采用便利抽样法,选取2023年6-7月在河北大学附属医院神经内科住院的245例首发老年脑卒中患者为研究对象,采用一般资料调查表、脑卒中患者心理痛苦温度计、领悟社会支持量表、心理弹性量表简化版、医学应对方式问卷对脑卒中患者进行问卷调查。采用Pearson相关分析探讨老年脑卒中患者心理痛苦与社会支持、心理弹性及应对方式的相关性,采用Harman单因素检验验证变量间是否存在共同方法偏差,通过SPSS软件宏程序PROCESS插件进行链式中介效应检验。结果本研究共发放问卷245份,回收有效问卷230份,问卷有效回收率为93.9%。230例老年脑卒中患者心理痛苦发生率为23.9%(55/230),心理痛苦、社会支持、心理弹性及应对方式间有相关性(P<0.05)。社会支持通过心理弹性和面对应对影响心理痛苦,总间接效应为-0.098;社会支持通过心理弹性和回避应对影响心理痛苦,总间接效应为-0.058;社会支持通过心理弹性屈服应对影响心理痛苦,总间接效应为-0.113;回避应对方式在社会支持对心理痛苦的影响具有遮掩效应。结论老年脑卒中患者心理痛苦水平处于中等偏下水平,心理弹性和应对方式在社会支持与心理痛苦间起链式中介效应,应多加关注社会支持程度低的老年脑卒中患者。

Objective To investigate the chain mediating role of psychological resilience and coping styles between social support and psychological distress in elderly stroke patients.Methods Using convenience sampling,245 elderly stroke patients with their first episode,admitted to the Neurology Department of the Affiliated Hospital of Hebei University from June to July 2023,were recruited as study subjects.A questionnaire survey was conducted using a General Information Questionnaire,Distress Thermometer for Stroke Patients,Perceived Social Support Scale,Connor-Davidson Resilience Scale Short Form,and Medical Coping Modes Questionnaire.Pearson correlation analysis was used to examine the relationships between psychological distress,social support,psychological resilience,and coping styles in elderly stroke patients.Harman's single-factor test was employed to detect common method bias among variables.The PROCESS macro in SPSS sofware was utilized to test the chain mediation effects.Results A total of 245 questionnaires were distributed,with 230 valid responses collected,yielding a response rate of 93.9%.Among the 230 elderly stroke patients,the incidence of psychological distress was 23.9%(55/230).Significant correlations were observed among psychological distress,social support,psychological resilience,and coping styles(P<0.05).Social support influenced psychological distress through the mediation of psychological resilience and confrontational coping,with a total indirect effect of-0.098.The same relationship existed for social support through psychological resilience and avoidant coping,with a total indirect effect of-0.058.Additionally,social support influenced psychological distress through psychological resilience and submissive coping,with a total indirect effect of-0.113.Avoidant coping had a suppressing effect on the influence of social support on psychological distress.ConclusionsElderly stroke patients experienced moderate to low levels of psychological distress.Psychological resilience and coping styles played a chain-mediating role between social support and psychological distress.Special attention should be given to elderly stroke patients with low levels of social support.