慢性心力衰竭患者的社会支持对治疗负担的影响:屈服应对的中介作用

Impact of Social Support on Treatment Burden in Patients with Chronic Heart Failure:Mediating Effect of Acceptance-resignation

目的了解慢性心力衰竭(chronic heart failure,CHF)患者的治疗负担现状,并探讨应对方式在社会支持和治疗负担之间的中介作用。方法便利抽样法选取广州市某三级甲等医院221名CHF患者为研究对象,采用慢性病共病患者治疗负担问卷、社会支持评定量表、医学应对方式问卷对其进行调查。结果CHF患者治疗负担总分为14.6(8.3,20.8)分、社会支持总分为(33.57±6.06)分。在应对方式中,面对14.0(11.0,16.0)分,回避16.0(15.0,16.0)分,屈服9.0(6.0,11.0)分。社会支持与治疗负担、屈服应对呈负相关(P<0.05);屈服应对与治疗负担呈正相关(P<0.05)。屈服应对是社会支持和治疗负担之间的中介变量(效应值:-0.154),中介效应占34.07%。结论CHF患者的社会支持可以通过屈服应对影响治疗负担。医务工作者在日常工作中要更加关注低社会支持的CHF患者,同时要引导患者采取积极的应对方式以减轻其治疗负担。

Objective To investigate the status quo of treatment burden in patients with CHF and to explore the mediating effect of coping style between social support and treatment burden.Methods A total of 221 patients with CHF from a tertiary A hospital in Guangzhou was selected by convenience sampling and surveyed with multimorbidity treatment burden questionnaire,social support revalued scale,and medical coping modes questionnaire.Results The total scores of treatment burden and social support in patients with CHF were 14.6(8.3,20.8)and(33.57±6.06),respectively.The sores of confrontation,avoidance and acceptance-resignation were 14.0(11.0,16.0),16.0(15.0,16.0)and 9.0(6.0,11.0).Social support was negatively associated with treatment burden and acceptance-resignation,while acceptance-resignation was positively related to treatment burden(P<0.05).Acceptance-resignation played a partial mediating role between social support and treatment burden(effect size:-0.154),with a mediating effect accounting for 34.07%.Conclusions Social support can influence treatment burden by acceptance-resignation.In order to lessen the treatment burden,medical professionals should pay special attention to patients without adequate social support,as well as guide them to adopt positive coping style.