健康自我管理能力对幽门螺杆菌阳性者疾病感知和知觉压力的中介效应

Mediating effect of health self-management ability on between disease perception and perceived stress in the patients with Helicobacter pylori positive subjects

目的探讨健康自我管理能力对幽门螺杆菌阳性者疾病感知和知觉压力的中介效应,为促进康复提供干预对策。方法选取2013年1月至9月山东第一医科大学附属消化病医院收治的400例幽门螺杆菌阳性消化系统疾病患者作为研究对象,采用成年人健康自我管理能力测评量表(AHSMSRS),简易版疾病感知问卷(BIPQ)和中文版知觉压力量表(CPSS)对其进行调查,采用Pearson相关性分析和线性回归分析,分析健康自我管理能力,疾病感知和知觉压力三者之间的关系。结果400例幽门螺杆菌阳性消化系统疾病患者AHSMSRS总分评分为(128.72±11.16)分,BIPQ总分评分为(47.42±6.16)分,CPSS总分评分为(36.13±5.26)分。相关分析显示结果显示,知觉压力与疾病感知呈负相关(r=-0.718,P<0.05),与健康自我管理能力呈负相关(r=-0.665,P<0.05),疾病感知与健康自我管理能力呈正相关(r=0.525,P<0.05)。线性回归分析结果显示,疾病感知是知觉压力的危险因素(β=-0.552,r=21.38,95%CI:0.500~0.604,P<0.01),健康自我管理能力是疾病感知的保护因素(β=0.485,t=19.28,95%CI:0.443~0.527,P<0.01);健康自我管理能力和疾病感知同时影响知觉压力(β=-0.259,P<0.05;β=-0.426,t=16.37,95%CI:0.358~0.494,P<0.01),健康自我管理能力和疾病感知是知觉压力的预测因素(P<0.01)。疾病感知对健康知觉压力的直接效应是0.585,健康自我管理能力在疾病感知与知觉压力之间的中介效应是0.264。Bootstrap检验结果显示,健康自我管理能力的中介效应的95%CI为0.096~0.125。结论健康自我管理能力能够显著性中介疾病感知和知觉压力二者之间的关系,提高健康自我管理能力有助于幽门螺杆菌阳性患者的身心康复。

Objective To explore the mediating effect of health self-management ability on between disease perception and perceived stress in the patients with Helicobacter pylori positive subjects,in order to provide intervention strategies for promoting rehabilitation.Methods Using the rating scale of health self-management skill for adults(AHSMSRS),the nrief illness perception questionnaire(BIPQ)and Chinese perceived stress scales(CPSS),four hundred patients with peptic ulcer caused by Helicobacter pylori were researched,the relationship of among health self-management ability,disease perception and health risk psychological stress were analyzed using Pearson correlation analysis and linear regression analysis.Results The total score of AHSMSRS was(128.72±11.16)points,the total score of BIPQ was(47.42±6.16)points,and the total score of CPSS(36.13±5.26)points.Correlation analysis showed health risk psychological stress was negatively correlated with disease perception(r=-0.718,P<0.05),it was negatively correlated with health self-management ability(r=-0.665,P<0.05).Disease perception was positively correlated with health self-management ability(r=0.525,P<0.05).The results of linear regression analysis showed that disease perception was a risk factor of perceived stress(β=-0.552,t=21.38,95%CI:0.500-0.604,P<0.01),health self-management ability was a protective factor of disease perception(β=0.485,t=19.28,95%CI:0.443-0.527,P<0.01).Both health self-management ability and disease perception affect perceived stress(β=-0.259,P<0.05;β=-0.426,t=16.37,95%CI:0.358-0.494,P<0.01),health self-management ability and disease perception were predictors of perceived stress(P<0.01).The direct effect of sickness perception to healthy psychological stress was 0.585,the direct mediating effect of health self-management ability between of disease perception and health risk psychological stress was 0.264.Health self-management ability is an influential factor of disease perception and health risk psychological stress,bootstrap test showed that 95%confidence interval of the mediating effect which health self-management ability was[0.96,0.158].Conclusion Health self-management ability is an influential factor of disease perception and health risk psychological stress,it can significantly mediate the relationship of between disease perception and health risk psychological stress,improving health self-management ability is conducive to promote physical and mental recovery of the patients with Helicobacter pylori positive subjects.