突发性聋患者应对方式在心理弹性与焦虑抑郁间的中介作用

Mediating effect of coping styles between psychological resilience and anxiety and depression in patients with sudden deafness

目的探讨突发性聋患者应对方式在心理弹性与焦虑抑郁间的中介作用。方法本研究为描述性研究,采用便利抽样法,选取2023年3—12月北部战区总医院耳鼻咽喉头颈外科收治的247例突发性聋患者,男169例,女78例,年龄(37.35±14.32)岁,年龄范围为18~79岁。采用一般资料调查表、医院焦虑抑郁量表、简易应对方式问卷及中文版心理弹性量表(CD-RISC)对其进行调查,并分析应对方式、心理弹性与焦虑抑郁间的关系。结果有无宗教信仰、合并疾病数量及伴随疾病数量的焦虑得分比较,差异有统计学意义(P<0.05);有无宗教信仰、合并疾病数量的抑郁得分比较,差异有统计学意义(P<0.05)。突发性聋患者心理弹性CD-RISC得分为(67.95±15.89)分,积极应对CD-RISC得分为(25.89±6.57)分,消极应对CD-RISC得分为(9.65±4.61)分,焦虑CD-RISC得分为(5.33±3.63)分,抑郁CD-RISC得分为(4.70±3.18)分。突发性聋患者心理弹性与积极应对(r=0.705)、消极应对与焦虑(r=0.364)、消极应对与抑郁(r=0.257)、焦虑与抑郁(r=0.659)呈正相关(P<0.05);心理弹性与消极应对(r=-0.158)、心理弹性与焦虑(r=-0.449)、心理弹性与抑郁(r=-0.632)、积极应对与消极应对(r=-0.086)、积极应对与焦虑(r=-0.462)、积极应对与抑郁(r=-0.612)呈负相关(P<0.05)。突发性聋患者应对方式具有部分中介作用,积极应对在心理弹性与焦虑之间的中介效应占总效应的45.43%(总效应量:-0.449,中介效应量:-0.204),消极应对在心理弹性与焦虑之间的中介效应占总效应的10.69%(总效应量:-0.449,中介效应量:-0.048);积极应对在心理弹性与抑郁之间的中介效应占总效应的36.87%(总效应量:-0.632,中介效应量:-0.233),消极应对在心理弹性与抑郁之间的中介效应占总效应的3.96%(总效应量:-0.632,中介效应量:-0.025)。结论心理弹性更多地通过积极应对方式间接影响焦虑抑郁,临床上应增强突发性聋患者的心理弹性,引导患者采取积极的应对方式,进而降低患者的焦虑抑郁水平。

Objective To explore the mediating effect of coping styles between psychological resilience and anxiety and depression in patients with sudden deafness.Methods This study was a descriptive study,using convenience sampling,a total of 247 patients were selected by convenience sampling method from the department of Otolaryngology Head and Neck Surgery of General Hospital of Northern Theater Command from March to December 2023,including 169 males and 78 females,aged(37.35±14.32)years old,ranging form 18 to 79 years old.General information questionnaire,hospital anxiety and depression scale,simplified coping style questionnaire and Chinese version of The Connor-Davidson Resilience Scale(CD-RISC)were used to investigate them and analyse the relationship between coping style,psychological resilience and anxiety and depression.Results Comparison of anxiety scores with or without religion,number of comorbidities and number of concomitant diseases,and depression scores with or without religion and number of comorbidities showed statistically significant differences(P<0.05).Sudden deafness patients had psychological resilience CD-RISC score were(67.95±15.89)points,positive coping CD-RISC score were(25.89±6.57)points,negative coping CD-RISC score were(9.65±4.61)points,anxiety CD-RISC score were(5.33±3.63)points,depression CD-RISC score were(4.70±3.18)points.Psychological resilience in patients with sudden deafness and positive coping(r=0.705),negative coping and anxiety(r=0.364),negative coping and depression(r=0.257),and anxiety and depression(r=0.659)were positively correlated(P<0.05);psychological resilience and negative coping(r=-0.158),psychological resilience and anxiety(r=-0.449),psychological resilience and depression(r=-0.632),positive coping and negative coping(r=-0.086),positive coping and anxiety(r=-0.462),and positive coping with depression(r=-0.612)were negatively correlated(P<0.05).Sudden deafness patients′coping styles had a partial mediating effect;the mediating effect of positive coping between psychological resilience and anxiety accounted for 45.43%of the total effect(total effect size:-0.449,mediating effect size:-0.204),and the mediating effect of negative coping between psychological resilience and anxiety accounted for 10.69%of the total effect(total effect size:-0.449,mediating effect size:-0.048);the mediating effect of positive coping between psychological resilience and depression was 36.87%of the total effect(total effect size:-0.632,mediating effect size:-0.233),and the mediating effect of negative coping between psychological resilience and depression was 3.96%of the total effect(total effect size:-0.632,mediating effect size:-0.025).Conclusions Psychological resilience affect anxiety and depression more indirectly through positive coping styles.Medical personnel should enhance the psychological resilience of patients with sudden deafness and encourage them to adopt positive coping styles,which in turn will reduce their anxiety and depression.