摘要
目的探讨疼痛接受在老年腰椎间盘突出症(LDH)患者心理一致感与应对策略间的中介作用。方法选取2022年1月—2023年4月医院门诊及住院的老年LDH患者为调查对象。采用一般资料调查表、应对策略问卷-修正版(CSQ-R)、心理一致感量表(SOC-13)、简易慢性疼痛接受问卷(CPAQ-8)进行调查。CPAQ-8、SOC-13评分与CSQ-R评分的相关性采用Pearson相关分析;采用线性回归分析疼痛接受的中介作用,并采用AMOS 21.0软件建立结构方程模型,评估中介效应。结果①本调查共发放259份问卷,收回252份有效问卷,有效率97.30%。②252例老年LDH患者CSQ-R评分69.30±6.77分,SOC-13评分61.85±9.66分,CPAQ-8评分25.03±5.26分。③Pearson相关性分析显示,老年LDH患者心理一致感、疼痛接受与应对策略均呈正相关(r=0.563、0.553,P<0.05)。④心理一致感可正向预测应对策略(b’=0.563,P<0.05)及疼痛接受(b’=0.559,P<0.05),分别解释31.4%、31.0%的变异。心理一致感、疼痛接受(b’=0.370、0.346)对应对策略有正向预测作用,可解释39.5%的变异,疼痛接受在心理一致感与应对策略间存在部分中介作用。⑤心理一致感对应对策略的效应值为0.259,疼痛接受在心理一致感与应对策略间的中介效应值为0.136(95%CI=0.072~0.220)。结论老年LDH患者的心理一致感能直接影响应对策略,也能通过疼痛接受间接影响应对策略,疼痛接受具有部分中介作用。
Objective To explore the mediating effect of pain acceptance on the relationship between psychological coherence and coping strategies in elderly patients with lumbar disc herniation(LDH).Methods To select elderly LDH patients in hospital outpatients and inpatients from January 2022 to April 2023 was as the survey subjects.The general information questionnaire,coping strategies questionnaire-revised(CSQ-R),sense of coherence-13(SOC-13),and chronic pain acceptance questionnaire-8(CPAQ-8)were used for investigation.The correlation between CPAQ-8,SOC-13 scores and CSQ-R scores was analyzed using Pearson correlation.Linear regression was used to analyze the mediating effect of pain acceptance,and AMOS 21.0 software was used to establish a structural equation model to evaluate the mediating effect.Results A total of 259 questionnaires were distributed in this survey,and 252 valid questionnaires were returned,with an effective rate of 97.30%.The CSQ-R score of 252 elderly patients with LDH was 69.30±6.77 points,the SOC-13 score was 61.85±9.66 points,and the CPAQ-8 score was 25.03±5.26 points.Pearson correlation analysis showed that there was a positive correlation between the psychological coherence,pain acceptance and coping strategies of elderly LDH patients(r=0.563,0.553,P<0.05).④Psychological coherence can positively predict coping strategies(b’=0.563,P<0.05)and pain acceptance(b’=0.559,P<0.05),explaining 31.4%and 31.0%of the variance respectively.Psychological coherence and pain acceptance(b’=0.370,0.346)had a positive predictive effect on coping strategies and can explain 39.5%of the variation.Pain acceptance had a partial mediating effect between psychological coherence and coping strategies.⑤The effect value of psychological coherence on coping strategies was 0.259,and the mediating effect value of pain acceptance between psychological coherence and coping strategies was 0.136(95%CI=0.072~0.220).Conclusion The sense of psychological coherence in elderly LDH patients can directly aff ect coping strategies,and can also indirectly aff ect coping strategies through pain acceptance.Pain acceptance plays a partial mediating role.
作者
刘芩慈
吁芬
周江玲
吴佳丽
王冬琴
LIU Qinci;YU Fen;ZHOU Jiangling;WU Jiali;WANG Dongqin(The 1st Affi liated Hospital,Jiangxi Medical College,Nanchang University,Nanchang 330006,China)
出处
《护理实践与研究》
2024年第3期325-333,共9页
Nursing Practice and Research
基金
江西省中医药管理局科技计划(编号:2021B298)。
关键词
椎间盘突出症
应对策略
疼痛接受
心理一致感
中介效应
Lumbar disc herniation
Coping strategies
Pain acceptance
Sense of coherence
Mediating effect
作者简介
通信作者:吁芬,本科,副主任护师,E-mail:785877169@qq.com。
