神经重症患者家属创伤后成长的影响因素及路径分析

doi:10.3761/j.issn.0254-1769.2021.06.006

摘要/Abstract

摘要：

目的了解神经重症患者家属创伤后成长现状,分析希望、感恩、心理弹性对创伤后成长的影响。方法 2019年1月—12月,采用便利抽样法,选取上海市某三级甲等医院神经外科ICU 340名患者家属作为研究对象。应用Herth希望量表、感恩问卷、心理弹性量表及创伤后成长评定量表对其进行调查。结果 340名神经重症患者家属创伤后成长总分为（73.38±14.02）分。患者家属创伤后成长与希望、感恩、心理弹性水平分别呈显著正相关（r=0.319、0.396、0.654,均P<0.01）。Bootstrap分析显示,感恩、心理弹性在希望和创伤后成长关系里的中介效应显著（95%CI为0.743~1.226）。希望可以分别通过感恩和心理弹性正向预测创伤后成长（β=0.145,P<0.01;β=0.734,P<0.01）,也可以通过感恩经心理弹性的多重中介正向预测创伤后成长（β=0.114,P<0.01）。结论感恩、心理弹性在希望与创伤后成长间起中介作用,护理管理者可通过构建基于感恩的干预策略,提高患者家属的心理弹性水平,促进创伤后成长。

关键词: 重症监护病房, 患者家属, 希望, 感恩, 心理弹性, 创伤后成长, 心理护理

Abstract:

Objective To understand the status quo of post-traumatic growth of family members of patients with severe neurological diseases,and to analyze the influence of hope,gratitude and resilience on post-traumatic growth. Methods From January to December 2019,340 family members of patients in a neurosurgical intensive care unit of a general tertiary hospital in Shanghai were collected by convenience sampling method. Herth Hope Index,Gratitude Questionnaire-Six-Item Form,Connor-Davidson Resilience Scale and Post-traumatic Growth Inventory were used for investigation them. Results The total post-traumatic growth score of 340 family members of patients with severe neurological disease was（73.38±14.02）. The post-traumatic growth of patients’ family members was positively correlated with the levels of hope,gratitude and resilience （r=0.319,0.396 and 0.654,all P<0.01）. Bootstrap analysis showed that gratitude and resilience had significant mediating effects on the relationship between hope and post-traumatic growth（95%CI：0.743~1.226）. It was hoped that gratitude and resilience could positively predict post-traumatic growth（β=0.145,P<0.01;β=0.734,P<0.01）,and post-traumatic growth could also be positively predicted through multiple mediators of gratitude sutra resilience （β=0.114,P<0.01）. Conclusion Gratitude and resilience play a mediating role in the relationship between hope and post-traumatic growth. Nursing managers can improve the level of mental resilience of patients’ family members and promote post-traumatic growth by constructing gratitude based interventions and education strategies.

Key words: Intensive Care Units, Family Member of Patients, Hope, Gratitude, Resilience, Post-Traumatic Growth, Psychological Nursing

林琪,董芳辉,曾莉,俞群亚,薛翌蔚. 神经重症患者家属创伤后成长的影响因素及路径分析[J]. 中华护理杂志, 2021, 56(6): 836-842.

LIN Qi,DONG Fanghui,ZENG Li,YU Qunya,XUE Yiwei. Analysis of influencing factors and pathway of post-traumatic growth in family members of neurosurgical intensive care unit patients[J]. Chinese Journal of Nursing, 2021, 56(6): 836-842.

图/表 3

表1 神经重症患者家属创伤后成长得分情况（n=340）

Table 1 Posttraumatic growth scores of family members of ICU patients in neurosurgery（n=340）

表2 神经重症患者家属创伤后成长与希望、感恩、心理弹性得分的相关性分析（r值,n=340）

Table 2 Correlation analysis of post-traumatic growth and scores of hope, gratitude and resilience in families of ICU patients in neurosurgery（r value,n=340）

图1 感恩和心理弹性在希望与创伤后成长之间的中介效应模型图

Figure 1 Model of the mediating effects of gratitude and resilience between hope and post-traumatic growth

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