發(fā)布時間：2018-04-29 21:39

  本文選題：腦卒中 + 家屬照顧者��； 參考：《北京中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:描述腦卒中患者家屬照顧者心理彈性、社會支持及應(yīng)對方式狀況;探討腦卒中患者家屬照顧者心理彈性的影響因素;分析腦卒中患者家屬照顧者心理彈性與社會支持和應(yīng)對方式的相關(guān)關(guān)系;探索腦卒中患者家屬照顧者的心理彈性在其社會支持與應(yīng)對方式之間的中介效應(yīng),為促進家屬照顧者對疾病及照顧工作采取積極的應(yīng)對方式,提供依據(jù)和指導(dǎo)。方法:本研究采用橫斷面調(diào)查方法,于2016年4月～2016年12月便利抽取北京市三所三級甲等醫(yī)院神經(jīng)內(nèi)科病房腦卒中患者及其家屬照顧者各236名。研究工具包括一般資料調(diào)查問卷、巴氏指數(shù)評定量表(Barthelindex,BI)、心理彈性量表(Connor-Davidson Resilience Scale,CD-RISC)、簡易應(yīng)對方式量表(Simplified Coping Style Questionnaire,SCSQ)和社會支持評定量表(Social Support Rating Scale,SSRS)。使用Excel軟件對數(shù)據(jù)進行錄入,利用SPSS 22.0統(tǒng)計軟件進行數(shù)據(jù)分析,統(tǒng)計方法包括描述性分析、t檢驗、方差分析、線性相關(guān)分析、多元線性逐步回歸分析等。結(jié)果:1.腦卒中患者家屬照顧者心理彈性平均得分為(69.46± 12.29)分;應(yīng)對方式方面,積極應(yīng)對的中位數(shù)和四分位數(shù)間距為25.00(8.00),消極應(yīng)對的中位數(shù)和四分位數(shù)間距是8.00(7.00);社會支持平均得分為(37.96±8.19)分。2.多元線性逐步回歸分析結(jié)果顯示,腦卒中患者家屬照顧者性別、文化程度、工作狀況、每天照顧時間、照顧壓力和積極應(yīng)對均進入多元線性回歸方程模型,能解釋39.80%的變異。3.相關(guān)分析結(jié)果顯示,腦卒中患者家屬照顧者心理彈性與積極應(yīng)對呈正相關(guān)(P0.01),與消極應(yīng)對呈負(fù)相關(guān)(P0.01);社會支持與心理彈性呈正相關(guān)(P0.05);社會支持與積極應(yīng)對呈正相關(guān)(P0.05),與消極應(yīng)對呈負(fù)相關(guān)(P0.05)。4.中介效應(yīng)分析結(jié)果顯示,腦卒中患者家屬照顧者的社會支持對其積極應(yīng)對方式的影響是通過心理彈性者的中介效應(yīng),中介效應(yīng)占總效應(yīng)的40.21%;社會支持對其消極應(yīng)對方式的影響是通過心理彈性者的中介效應(yīng),中介效應(yīng)占總效應(yīng)的16.73%。結(jié)論:1.腦卒中患者家屬照顧者心理彈性呈中等水平,表明照顧者對逆境有一定的反彈能力;積極應(yīng)對水平處于中等,消極應(yīng)對水平偏低;社會支持總體處于中上等水平,說明照顧者的社會支持水平較好。2.腦卒中患者家屬照顧者心理彈性的影響因素包括性別、文化程度、工作狀況、每天照顧時間、照顧壓力和積極應(yīng)對。3.腦卒中患者家屬照顧者心理彈性、社會支持及心理彈性具有相關(guān)性,即心理彈性水平和社會支持水平高的家屬照顧者,越傾向采取積極應(yīng)對方式;照顧者的社會支持度越高,其心理彈性越高。4.腦卒中患者家屬照顧者的社會支持通過心理彈性的中介效應(yīng)對,從而影響其應(yīng)對方式,表明護理工作者可通過提高家屬照顧者的社會支持水平,增強其心理彈性,從而間接引導(dǎo)照顧者采取積極的認(rèn)知和行為策略。
[Abstract]:Objective: to describe the psychological elasticity, social support and coping style of family caregivers of stroke patients, and to explore the influencing factors of family caregivers' mental resilience. The relationship between family caregivers' psychological elasticity and social support and coping style was analyzed, and the mediating effect of family caregivers' psychological elasticity between social support and coping style was explored. In order to promote the family caregivers to take a positive response to disease and care, provide the basis and guidance. Methods: from April 2016 to December 2016, 236 stroke patients and their relatives in neurology wards of three Grade 3A hospitals in Beijing were selected by cross-sectional investigation. The research tools included general data questionnaire, Barthel Index scale, Connor-Davidson Resilience scale, simplified Coping Style questionnaire and Social support scale. The Excel software is used to input the data and the SPSS 22.0 statistical software is used to analyze the data. The statistical methods include descriptive analysis t test, variance analysis, linear correlation analysis, multivariate linear stepwise regression analysis and so on. The result is 1: 1. The average score of psychological elasticity was 69.46 鹵12.29, the median and quartile spacing of positive coping was 25.00 鹵8.00, the median and quartile spacing of negative coping was 8.00 鹵7.00, and the average score of social support was 37.96 鹵8.19). The results of multiple linear stepwise regression analysis showed that the gender, education level, working condition, care time, care stress and positive coping of relatives of stroke patients were all involved in the multiple linear regression equation model, which could explain 39.80% of the variation. 3. The results of correlation analysis show that There was a positive correlation between psychological elasticity and positive coping in family caregivers of stroke patients, a negative correlation between social support and negative coping, a positive correlation between social support and mental resilience, a positive correlation between social support and positive coping, and a negative correlation between social support and negative coping. The results of intermediary effect analysis showed that the influence of social support of family caregivers on the positive coping style of stroke patients was mediated by the psychological flexibility. The mediating effect accounts for 40.21% of the total effect, and the influence of social support on its negative coping style is through the intermediary effect of the person with psychological elasticity, and the intermediary effect accounts for 16.73% of the total effect. Conclusion 1. The psychological elasticity of caregivers of stroke patients' family members showed a moderate level, indicating that caregivers had a certain ability to rebound against adversity; positive coping level was medium, negative coping level was low; social support was generally at the middle and upper level. The social support level of caretaker is better. 2. 2. The factors influencing the mental resilience of family caregivers of stroke patients included gender, education level, work status, care time per day, care stress and positive coping. 3. The family caregivers of stroke patients were more likely to adopt the positive coping style, and the social support and the psychological elasticity were correlated, that is, the family caregivers with high level of psychological elasticity and social support were more likely to adopt the positive coping style, and the social support of the caregivers was higher. Their psychological resilience is higher. 4. The social support of caregivers of family members of stroke patients affected their coping style through the intermediary effect of psychological elasticity, which indicated that nursing workers could enhance their psychological resilience by improving the level of social support of family caregivers. Thus indirectly guide caregivers to adopt positive cognitive and behavioral strategies.
【學(xué)位授予單位】：北京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R473.74

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