本文選題：腎移植受者 + 健康相關(guān)的生活質(zhì)量　； 參考：《北京中醫(yī)藥大學(xué)》2015年碩士論文

【摘要】：[目的]基于壓力與應(yīng)對(duì)理論,調(diào)查腎移植受者的壓力、自我效能、領(lǐng)悟社會(huì)支持、健康認(rèn)知初級(jí)評(píng)價(jià)、應(yīng)對(duì)方式和健康相關(guān)的生活質(zhì)量,驗(yàn)證假設(shè)理論模型,探討腎移植受者的健康相關(guān)的生活質(zhì)量的影響因素。[方法]在武警總醫(yī)院移植隨訪門診,以問卷形式調(diào)查了220名符合納入排除標(biāo)準(zhǔn)的腎移植受者。應(yīng)用健康簡明量表SF-36調(diào)查腎移植受者健康相關(guān)的生活質(zhì)量；應(yīng)用醫(yī)學(xué)應(yīng)對(duì)問卷(MCMQ)調(diào)查腎移植受者的應(yīng)對(duì)方式；應(yīng)用領(lǐng)悟社會(huì)支持量表(PSSS)調(diào)查腎移植受者的社會(huì)支持水平；應(yīng)用感知健康能力量表(PHCS)調(diào)查腎移植受者的自我效能水平；健康認(rèn)知評(píng)價(jià)量表(CAHS)調(diào)查腎移植受者對(duì)與健康有關(guān)的潛在的壓力事件的評(píng)價(jià)。采用SPSS21.0軟件包對(duì)數(shù)據(jù)進(jìn)行描述性分析、t檢驗(yàn)、相關(guān)分析,采用AMOS21.0軟件對(duì)假設(shè)模型進(jìn)行驗(yàn)證性分析,確定自變量對(duì)因變量的作用路徑。[結(jié)果]回收有效問卷202份,腎移植受者平均年齡為43.69±11.25歲。路徑分析結(jié)果顯示,在腎移植受者生理健康影響因素修正模型中,自我效能對(duì)負(fù)性評(píng)價(jià)有直接負(fù)性效應(yīng)(β=-0.30),對(duì)其“屈服”應(yīng)對(duì)方式有直接負(fù)性效應(yīng)(β=-0.16)以及通過健康認(rèn)知評(píng)價(jià)對(duì)“屈服”應(yīng)對(duì)方式有間接負(fù)性效應(yīng)(β=-0.13),對(duì)生理健康有直接正向效應(yīng)(β=0.23)和間接正向效應(yīng)(β=0.13)。領(lǐng)悟社會(huì)支持對(duì)其健康認(rèn)知初級(jí)評(píng)價(jià)有負(fù)向直接效應(yīng)(β=-0.12)；對(duì)其“屈服”應(yīng)對(duì)方式有負(fù)向直接效應(yīng)(β=-0.14)和負(fù)向間接效應(yīng)(β=-0.05)。藥物副作用癥狀影響對(duì)其“屈服”應(yīng)對(duì)方式有正向直接效應(yīng)(β=0.15)間接正向效應(yīng)(β=0.10),對(duì)其“回避”應(yīng)對(duì)方式有直接正向效應(yīng)(β=0.27)。在腎移植受者心理健康影響因素修正模型中,自我效能對(duì)其負(fù)性評(píng)價(jià)有直接負(fù)性效應(yīng)(β=-0.31),對(duì)其“屈服”應(yīng)對(duì)方式有直接負(fù)性效應(yīng)(β=-0.15)和間接負(fù)性效應(yīng)(β=-0.14)；領(lǐng)悟社會(huì)支持對(duì)其健康認(rèn)知初級(jí)評(píng)價(jià)有負(fù)向直接效應(yīng)(β=-0.12)；對(duì)其“屈服”應(yīng)對(duì)方式有負(fù)向直接效應(yīng)(β=-0.14,P=0.01)和負(fù)向間接效應(yīng)(β=-0.05),對(duì)其心理健康有正向直接效應(yīng)(β=0.14)和正向間接效應(yīng)(β=0.07)。藥物副作用癥狀影響對(duì)其“屈服”應(yīng)對(duì)方式有正向直接效應(yīng)(β＝0.15)和間接正向效應(yīng)(β=0.10),對(duì)其“回避”應(yīng)對(duì)方式有直接正向效應(yīng)(β=0.25)和間接正向效應(yīng)(β=0.01)；對(duì)其心理健康有負(fù)向直接效應(yīng)(β=-0.21)和負(fù)向間接效應(yīng)(β=-0.11)。腎移植受者對(duì)健康壓力的初級(jí)負(fù)性評(píng)價(jià)對(duì)其“屈服”應(yīng)對(duì)方式有直接正向效應(yīng)(β=0.45),對(duì)其生理和心理健康有負(fù)性直接效應(yīng)(β=-0.32)和負(fù)性的間接效應(yīng)(β=-0.15)。腎移植受者的“屈服”應(yīng)對(duì)方式對(duì)其心理健康有負(fù)性直接效應(yīng)(β=-0.20)。經(jīng)濟(jì)負(fù)擔(dān)(β=0.15)、肌酐指標(biāo)(β=0.15)以及藥物副作用癥狀影響對(duì)其健康認(rèn)知的初級(jí)負(fù)性評(píng)價(jià)有直接正向效應(yīng)(β=0.22)。,對(duì)心理健康有負(fù)向直接效應(yīng)(β=-0.21)。研究中納入的外因變量可以解釋腎移植受者生理和心理健康30%和38%的變異量。[結(jié)論]在本研究中,通過對(duì)假設(shè)模型的驗(yàn)證,“經(jīng)濟(jì)負(fù)擔(dān)”“、”“生化指標(biāo)-肌酐”“和“藥物副作用癥狀影響”會(huì)被腎移植受者評(píng)價(jià)為壓力,壓力越大,越傾向于負(fù)性評(píng)價(jià),進(jìn)而影響受者采取何種方式應(yīng)對(duì)壓力；“屈服”應(yīng)對(duì)方式會(huì)直接有損于受者的心理健康。腎移植受者健康相關(guān)的生活質(zhì)量受到很多復(fù)雜因素的影響,各個(gè)因素通過不同的路徑最終影響受者的生活質(zhì)量,在今后對(duì)腎移植受者健康相關(guān)的生活質(zhì)量研究中,進(jìn)一步對(duì)影響因素進(jìn)行分組,深入探討影響因素對(duì)受者生活質(zhì)量影響的機(jī)制。
[Abstract]:[Objective] to investigate the pressure, self efficacy, understanding of social support, primary evaluation of health cognition, coping style and health related quality of life based on pressure and coping theory, and to verify the hypothesis model and explore the factors affecting the health related quality of life in renal transplant recipients. [Methods] transplant follow-up in general hospital of armed police. A questionnaire was used to investigate 220 renal transplant recipients who met the exclusion criteria. A health concise scale SF-36 was used to investigate the health related quality of life related to renal transplant recipients; the Medical Coping Questionnaire (MCMQ) was used to investigate the coping styles of renal transplant recipients; and the social support scale (PSSS) was used to investigate the social support of renal transplant recipients. Holding the level; using the perceived health ability scale (PHCS) to investigate the self-efficacy level of renal transplant recipients; the health cognition Assessment Scale (CAHS) was used to investigate the evaluation of the potential stress events related to the health of kidney transplant recipients. The data were analyzed by the SPSS21.0 software package, the t test, the correlation analysis, and the AMOS21.0 software. A model was set up to verify the effect of the independent variable on the dependent variable. [results] 202 valid questionnaires were recovered and the average age of renal transplant recipients was 43.69 + 11.25 years. The results of path analysis showed that the self efficacy had a direct negative effect on negative evaluation in the model of the factors affecting the physiological health factors of the recipients of renal transplantation (beta =-0.30), Its "yield" coping style had direct negative effect (beta =-0.16) and indirect negative effect (beta =-0.13) on "yield" coping style through health cognition assessment (beta =-0.13), and direct positive effect (beta =0.23) and indirect positive effect (beta =0.13) on physiological health. 12); there were negative direct effect (beta =-0.14) and negative indirect effect (beta =-0.05) on its "yield" coping style. The effect of drug side effects on its "yield" coping style had a positive direct effect (beta =0.15), and the "avoidance" should have a direct positive effect on the way of "avoiding" (beta =0.27). In the health impact factor correction model, self efficacy has a direct negative effect on its negative evaluation (beta =-0.31), which has a direct negative effect (beta =-0.15) and indirect negative effect (beta =-0.14) on the "yield" coping style, and the perceived social support has a negative direct effect on its primary evaluation of health cognition (beta =-0.12), and its "yield" response to it. The negative direct effect (beta =-0.14, P=0.01) and negative indirect effect (beta =-0.05) have positive direct effect (beta =0.14) and positive indirect effect (beta =0.07) on their mental health. The effect of side effects on the "yield" coping style has positive direct effect (beta = 0.15) and indirect positive effect (beta =0.10) on its "avoidance" response. There were direct positive effects (beta =0.25) and indirect positive effect (beta =0.01), negative direct effect (beta =-0.21) and negative indirect effect (beta =-0.11) on their mental health. The primary negative evaluation of renal transplant recipients had direct positive effect on their "yield" coping style (beta =0.45), and negative to their physiological and psychological health. Direct effect (beta =-0.32) and negative indirect effect (beta =-0.15). The "yield" coping style of renal transplant recipients has a negative direct effect on their mental health (beta =-0.20). The economic burden (beta =0.15), creatinine index (beta =0.15) and drug side effects have a direct positive effect on the primary negative evaluation of their health cognition (beta =0.22). Psychological health has a negative direct effect (beta =-0.21). The exogenous variables included in the study can explain the variation in physiological and psychological health of 30% and 38% in renal transplant recipients. [Conclusion] in this study, the "economic burden" "," "biochemical indicators muscle anhydride" and "the effect of the side effects of drug" in this study will be treated by the kidney. The greater the stress, the greater the stress, the more the stress, the more negative evaluation, and then the way the recipient takes the stress. The "yield" coping style will directly damage the psychological health of the recipient. The health related quality of life of the recipients of the renal transplant recipients is influenced by many complex factors, and the factors are finally influenced by different paths. The quality of life of the recipients, in the future study of the health related quality of life of the recipients of renal transplantation, further study the influencing factors and explore the mechanism of influence factors on the quality of life of the recipients.

【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R473.6

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