抑郁在老年骨质疏松性髋部骨折术后患者自我效能感和生活质量之间的中介作用

Mediating effect of depression on self-efficacy and quality of life in elderly patients with osteoporotic hip fracture

目的探讨老年骨质疏松性髋部骨折术后患者抑郁、自我效能感和生活质量的关系,以及抑郁在自我效能感和生活质量间的中介作用。方法采用整群随机抽样法,选取哈尔滨市2所三级甲等综合医院收治的300例老年骨质疏松性髋部骨折术后患者为研究对象,采用贝克抑郁量表第2版、一般自我效能感量表、世界卫生组织生存质量测定简表进行问卷调查。结果患者自我效能感和生活质量各领域得分呈正相关(r=0.281～0.605,P<0.01)、患者抑郁与自我效能感和生活质量各领域得分呈负相关(r=-0.372～-0.255,P<0.01);抑郁在自我效能感和生理领域、心理领域、社会关系领域、环境领域之间具有部分中介作用。结论老年骨质疏松性髋部骨折术后患者有轻度抑郁情绪,患者自我效能感和生活质量都较差,抑郁在自我效能感和生活质量各领域之间具有部分中介作用,应制订相应的干预措施提高自我效能感,降低患者的抑郁情绪,从而提高患者的生活质量。

Objective To explore the relationship between depression, self-efficacy and quality of life in elderly patients with osteoporotic hip fracture,and the mediating effect of depression on self-efficacy and quality of life.Methods The group randomized sampling method was used to select 300 elderly patients with osteoporotic hip fractures from 2 3A-level general hospitals in Harbin.The Second Edition of The Beck Depression Inventory,General Self-efficacy Scale,World Health Organization on Quality of Life Brief Scale(WHOQOL-BREF)were used for the survey.Results There was a positive correlation between the patient’s general self-efficacy and areas of quality of life scores(r= 0.281~0.605,P<0.01).There was a negative correlation among the patient’s depression and self-efficacy and areas of quality of life scores(r=-0.372^-0.255,P<0.01).Depression played a part of the mediating effect between self-efficacy and quality of life in the physical field,the psychological field,the social relations field and the environmental field.Conclusion Elder patients with osteoporotic hip fracture surgery have mild depression,patients with poor self-efficacy and quality of life,depression could mediate the relationship between self-efficacy and quality of life.The corresponding intervention measures should be formulated to improve the self-efficacy,reduce the depression of the patient,and thus improve the quality of life of the patient.