作者：龚玥,王萍,郑雪梅

单位：

210000 江苏省南京市，南京医科大学附属南京医院 南京市第一医院心血管内科 通信作者：郑雪梅，E-mail：xmzheng@163.com

Units：

Department of Cardiology, Nanjing First Hospital, Nanjing Medical University/Nanjing First Hospital, Nanjing 210000，China Corresponding author: ZHENG Xuemei, E-mail: xmzheng@163.com

关键词：

心力衰竭; 家庭坚韧性; 正性情绪; 积极应对方式; 相依关系;

Keywords：

Heart failure; Family resilience; Positive emotion; Positive coping style; Mutuality

CLC：

DOI：

10.12114/j.issn.1008-5971.2021.00.277

Funds：

2016 年度南京市医学科技发展项目（YKK16144）

摘要：

背景慢性心力衰竭(CHF)作为常见慢性病之一,在长期治疗过程中患者不仅应掌握一定的疾病知识和自我管理能力,还应具备正性情绪、积极应对方式等良好的心理素质。目前,国内对CHF患者家庭坚韧性、正性情绪、积极应对方式、相依关系间关系的研究较少。目的 探讨相依关系在CHF患者家庭坚韧性、正性情绪、积极应对方式间的中介作用,以期为制定提高CHF患者家庭坚韧性的护理干预方案提供参考依据。方法 选取2020年7月至2021年4月南京市第一医院收治的260例CHF患者为研究对象,采用一般资料调查表、家庭坚韧性量表(FHI)、正性负性情绪量表(PNAS)、简易应对方式问卷(SCSQ)、相依关系量表(MS)评估患者的一般资料、家庭坚韧性、正性情绪、积极应对方式及相依关系。采用Pearson相关分析探讨CHF患者FHI及其各维度、正性情绪量表、积极应对方式问卷、MS及其各维度得分间的相关性;采用Bootstrap自助抽样法对相依关系在CHF患者家庭坚韧性与正性情绪、家庭坚韧性与积极应对方式间的中介作用进行验证。结果 本研究CHF患者FHI、正性情绪量表、积极应对方式问卷、MS得分分别为(56.24±10.95)、(30.14±7.34)、(23.69±6.05)、(43.10±8.84)分。Pearson相关分析结果显示,CHF患者FHI及其各维度、正性情绪量表、积极应对方式问卷、MS及其各维度得分间均呈正相关(P <0.05)。相依关系在CHF患者家庭坚韧性与正性情绪、积极应对方式间均起部分中介作用(β值分别为0.449、0.396,P值均<0.001)。Bootstrap自助抽样法结果显示,相依关系在CHF患者家庭坚韧性与正性情绪、家庭坚韧性与积极应对方式间间接效应的路径系数的95%CI分别为(0.210,0628)、(0.487,0.536),提示相依关系在CHF患者家庭坚韧性与正性情绪、积极应对方式间的部分中介效应显著。结论 CHF患者家庭坚韧性处于中等水平,其与正性情绪、积极应对方式和相依关系均呈正相关,且相依关系在CHF患者家庭坚韧性与正性情绪、积极应对方式间均具有部分中介作用。

Abstract：

【Abstract】　Background Chronic heart failure (CHF) is one of the most common chronic diseases, and patients shouldnot only master a certain levels of knowledge and self-management skills, but also have positive emotion and positive coping styleduring the long treatment process. At present, there is little research on the relationship among family resilience, positive emotion,positive coping style and mutuality in CHF patients in China. Objective To discuss mediating effect of mutuality between familyresilience and positive emotion, positive copying style in patients with CHF, in order to provide a reference for making nursingintervention plan to improve family resilience in CHF patients. Methods Two hundred and sixty patients with CHF admittedto Nanjing First Hospital from July 2020 to April 2021 were selected as the research objects. General Information Questionnaire,Family Hardiness Index (FHI) , Positive and Negative Affect Scale (PNAS) , Simple Coping Style Questionnaire (SCSQ) andMutuality Scale (MS) were used to investigate patients' general information, family resilience, positive emotion, positive copyingstyle and mutuality. Pearson correlation analysis was used to discuss the correlation among scores of FHI and its dimensions,Positive Emotion Scale, Positive Coping Style Questionnaire, MS and its dimensions in CHF patients, and Bootstrap self-samplingmethod was used to verify the mediating effect of mutuality between family resilience and positive emotion, positive coping style inCHF patients. Results In this study, scores of FHI, Positive Emotion Scale, Positive Coping Style Questionnaire and MS of CHFpatients was (56.24±10.95) , (30.14±7.34) , (23.69±6.05) , (43.10±8.84) , respectively. Pearson correlation analysis resultsshowed that, scores of FHI and its dimensions, Positive Emotion Scale, Positive Coping Style Questionnaire, MS and its dimensionsof CHF patients were positively correlated with each other (P < 0.05) . Mutuality played a partial mediating effect between familyresilience and positive emotion, positive coping style in CHF patients (βvalue were 0.449, 0.396, respentively, P values both< 0.001) . Bootstrap self-sampling method showed that, the 95%CI of path coefficient of indirect effects of mutuality betweenfamily resilience and positive emotion, positive coping style of CHF patients was (0.210, 0628) , (0.487, 0.536) , respectively. Itis suggested that mutuality had a significant partial mediating effect between family resilience and positive emotion and positivecoping style in CHF patients. Conclusion Family resilience level of CHF patients is moderate, and is positively related withpositive emotion, positive coping style and mutuality, and mutuality plays a partial mediating effect between family resilience andpositive emotion, positive coping style in CHF patients

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