本文選題：住院病人 + 心理應(yīng)激反應(yīng)�。� 參考：《中南大學(xué)》2007年碩士論文

【摘要】： 目的：檢驗醫(yī)院應(yīng)激量表中文版的信效度，，在此基礎(chǔ)上，對住院患者的應(yīng)激源、中介機(jī)制、心理應(yīng)激反應(yīng)進(jìn)行一個全面而整體的研究，建立一個住院病人心理應(yīng)激反應(yīng)及其影響因素的結(jié)構(gòu)方程模型，明確影響住院患者心理狀況的主要因素之間的相互關(guān)系，從整體角度探明這些因素對心理反應(yīng)的作用方式和貢獻(xiàn)大小。 方法：本研究為橫斷面調(diào)查研究。采取分層--隨機(jī)--整群抽樣方法，抽取2006年9月到2007年3月在長沙市八所省級和市級醫(yī)院住院的非精神科住院病人754例，使用相應(yīng)量表調(diào)查住院病人的應(yīng)激源、應(yīng)對方式、自我效能、社會支持、人格和住院的心理反應(yīng)。 使用SPSS 13．0對所有資料進(jìn)行統(tǒng)計描述、方差分析、相關(guān)分析、多元線性回歸分析，使用LISREL8．70對各量表進(jìn)行驗證性因素分析，并在以上統(tǒng)計分析基礎(chǔ)上進(jìn)行結(jié)構(gòu)方程的建構(gòu)、修正和評價。 結(jié)果：1．大部分量表的cronbach's alpha系數(shù)大于0.6，條目間平均相關(guān)系數(shù)(MIC)在0.10-0.50之間，尤其是住院病人心理評定量表的信度比較好；醫(yī)院應(yīng)激評定量表α系數(shù)為0.843，MIC為0.102，分量表的α系數(shù)為0.47～0.73，各分量表條目MIC在0.1～0.2之間，總量表及各維度的重測信度均在0.60以上。各量表效度也達(dá)到測量學(xué)要求(CFI，IFI，GFI均大于0.90，RMSEA＜0.10)。2．進(jìn)入構(gòu)建結(jié)構(gòu)方程模型的中介變量為：醫(yī)院應(yīng)激、支持、病程、經(jīng)濟(jì)、自我效能、神經(jīng)質(zhì)、內(nèi)外向、回避。3．結(jié)構(gòu)方程模型擬合較好：X~2／df＜3，CFI，IFI，GFI均大于0.90，RMSEA＜0.05。 結(jié)論：1．本研究構(gòu)建出一個住院病人的心理應(yīng)激模型，具有較好的擬合指數(shù)。2．該模型顯示自我效能是一個重要的中介變量，應(yīng)對方式“屈服”對心理狀況的影響也很大；醫(yī)院應(yīng)激除了直接作用于心理狀況，還通過回避、屈服、神經(jīng)質(zhì)對心理狀況起間接作用；回避、屈服、神經(jīng)質(zhì)、內(nèi)外向、社會支持除了直接作用于心理狀況，還部分通過自我效能對心理狀況產(chǎn)生影響；病程和經(jīng)濟(jì)地位對病人的心理狀況有直接的影響，同時經(jīng)濟(jì)地位也可以影響社會支持。3．醫(yī)院應(yīng)激評定量表的信度和效度基本達(dá)到要求，可以在調(diào)查中使用。
[Abstract]:Objective: to test the reliability and validity of the Chinese version of the Hospital stress scale, and to conduct a comprehensive and holistic study on the stressors, mediators and psychological stress responses of the inpatients on the basis of the reliability and validity of the Chinese version of the scale. To establish a structural equation model of psychological stress response and its influencing factors of inpatients, and to clarify the relationship between the main factors that affect the psychological status of hospitalized patients. From the overall point of view, the effects of these factors on psychological response and contribution. Methods: this study is a cross-sectional investigation. From September 2006 to March 2007, 754 non-psychiatric inpatients in eight provincial and municipal hospitals in Changsha were selected by stratified random-cluster sampling. The stressors and coping styles of inpatients were investigated with the corresponding scale. Self-efficacy, social support, personality, and psychological response to hospitalization. SPSS 13.0 was used to describe all the data, ANOVA, correlation analysis, multivariate linear regression analysis, LISREL8.70 to verify the factors of each scale, and on the basis of the above statistical analysis to construct the structural equation. Revision and evaluation The result is 1: 1. The cronbach's alpha coefficient of most scales was greater than 0.6, and the average correlation coefficient between items was between 0.10-0.50, especially the reliability of psychological rating scale for inpatients was better. The 偽 coefficient of hospital stress rating scale was 0.843 and 0.102, and the 偽 coefficient of component scale was 0.470.73. The MIC of each subscale item was between 0.1 and 0.2, and the test-retest reliability of the total scale and each dimension was more than 0.60. The validity of each scale also met the requirement of measurement. The GFI of CFI and IFI was higher than 0.90 RMSEA < 0.10g 路2. The intermediate variables involved in structure-equation model are: hospital stress, support, course of disease, economy, self-efficacy, neuroticism, introversion and extroversion. The structure equation model fits well with the structure equation model. The structure equation model is more than 0.90% RMSEA < 0.05, and the CFI GFI is less than 3%. Conclusion 1. In this study, a psychological stress model of inpatients was constructed, with a good fitting index. 2. 2. The model shows that self-efficacy is an important intermediary variable, and the coping style "surrender" has a great influence on psychological condition. Neuroticism plays an indirect role in mental state, avoidance, submission, neuroticism, introversion, social support not only act directly on mental state, but also influence mental state partly through self-efficacy. Course of disease and economic status have a direct impact on the psychological status of patients, and economic status can also affect social support. 3. The reliability and validity of the hospital stress rating scale can be used in the investigation.
【學(xué)位授予單位】：中南大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2007
【分類號】：R395

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