文章摘要
李歆,底盼盼,张琳,等.家庭功能在初发脑卒中后抑郁病人病耻感与不良情绪间的中介作用分析[J].安徽医药,2024,28(3):538-541.
家庭功能在初发脑卒中后抑郁病人病耻感与不良情绪间的中介作用分析
Analysis of the role of family functioning in mediating the relationship between stigma and dysphoria in depressed patients after initial stroke
  
DOI:10.3969/j.issn.1009-6469.2024.03.024
中文关键词: 卒中  家庭功能  抑郁症  病耻感  不良情绪  中介作用
英文关键词: Stroke  Family functioning  Depressive disorder  Morbidity stigma  Dysphoria  Mediating role
基金项目:河北省中医药管理局 2020年度中医药类科研计划课题( 2020287)
作者单位E-mail
李歆 石家庄市妇幼保健院护理部河北石家庄 050000  
底盼盼 石家庄市妇幼保健院重症医学科河北石家庄 050000  
张琳 石家庄市妇幼保健院康复科河北石家庄 050000  
李娜 石家庄市妇幼保健院儿科河北石家庄 050000  
刘丽洁 石家庄市妇幼保健院心理科河北石家庄 050000 du75627@21cn.com 
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中文摘要:
      目的探讨家庭功能在初发脑卒中后抑郁( PSD)病人病耻感与不良情绪间的中介作用,为促进 PSD病人身心健康提供临床依据。方法选取 2019年 1月至 2021年 5月在石家庄市妇幼保健院收治的 231例初发 PSD病人作为研究对象,采用激惹、抑郁和焦虑自评量表( IDA)、脑卒中病人病耻感量表( SSS)及家庭功能评价量表( APGAR)评估研究对象不良情绪、病耻感及家庭功能状况,并采用 Pearson法分析三者间的相关性,结构方程模型进一步检验家庭功能在病耻感与负性情绪间的中介效应。结果初发 PSD病人 IDA评分( 62.32±5.85)分, SSS评分( 57.69±4.10)分, APGAR评分( 4.56±2.10)分; Pearson相关性分析得知, PSD病人 APGAR评分与 SSS评分呈负相关( r=.0.44,P<0.001)与 IDA评分呈负相关( r=.0.49,P<0.001)SSS评分与 IDA评分呈正相关( r=0.47,P<0.001);中介模型提示,家庭功能在病耻感与,不良情绪间起中介作用( β=0.36,P<0.001),。本研究中,间接效应 >直接效应,中介效应占总效应的比值为( .0.662)×(.0.538)/0.462=77.09%。结论初发 PSD病人的病耻感能直接预测不良情绪,但家庭功能能发挥中介调节效应,纠正不良情绪,减轻病耻感,故在临床工作中,应充分给予初发 PSD病人家庭支持,以促进其身心健康发展。
英文摘要:
      Objective To investigate the mediating role of family functioning between stigma and dysphoria in patients with primary post-stroke depression (PSD), and to provide a clinical basis for promoting physical and mental health in patients with PSD.Methods Two hundred and thirty-one patients with first-onset PSD admitted to Shijiazhuang Maternal and Child Health Hospital from January2019 and May 2021 were selected as study subjects, and the Self-Rating Inventory of Irritation, Depression and Anxiety (IDA), the Sick.ness Stigma Scale for Stroke Patients (SSS) and the Assessment of Family Functioning Scale (APGAR) were used to assess the status ofdysphoria, sickness stigma and family functioning in the study subjects, and the Pearson method was used to analyze the correlation be.tween the three, and structural equation modeling was used to further test the mediating effect of family functioning between sicknessstigma and negative emotions.Results IDA score, SSS score and APGAR score in patients with first-onset PSD were (62.32±5.85),(57.69±4.10), (4.56±2.10), respectively. Pearson correlation analysis revealed that APGAR scores of PSD patients were negatively cor.related with SSS scores (r=.0.44, P<0.001), negatively correlated with IDA scores (r=.0.49, P<0.001), and SSS scores were positively correlated with IDA scores (r=0.47, P<0.001). The mediation model suggested that family functioning mediated the relationship be.tween morbidity stigma and dysphoria (β=0.36, P<0.001). In this study, the indirect effect was greater than the direct effect, and the ra.tio of the mediating effect to the total effect was (.0.662) × (.0.538)/0.462=77.09%.Conclusions The morbid stigma of patients with first-onset PSD can directly predict the bad mood, but family function can play a mediating moderating effect to correct the bad moodand reduce the morbid stigma. Therefore, family support should be given to patients with first-onset PSD adequately to promote their healthy physical and mental development in clinical work.
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