心理一致感在脑卒中患者心理压力与抑郁间的中介作用
Mediating effects of sense of coherence between mental stress and depression in stroke patients
目的?分析心理一致感在脑卒中患者心理压力与抑郁间的中介作用,为减轻卒中患者心理压力、减少抑郁发生和促进其心理健康提供指导和帮助.方法?于2016年7月—2017年7月方便抽取河南省郑州市某三级甲等医院神经内科脑卒中患者468例,对其采用心理一致感量表(SOC-13)、中文版知觉压力量表(CPSS)和流调中心抑郁量表(CES-D)进行调查,并采用SPSS 21.0软件和AMOS 22.0软件对数据进行统计分析.结果?脑卒中患者SOC-13、CPSS、CES-D量表总均分分别为(63.39±9.92)、(41.65±7.29)、(23.80±4.20)分.心理一致感与心理压力、抑郁均呈负相关(r值分别为-0.47、-0.51;P<0.01),心理压力与抑郁则呈正相关(r=0.52,P<0.01).心理一致感作为中介变量,使心理压力对抑郁的不良预测效应从0.632下降到0.283.结构方程模型再次分析结果显示,心理一致感是心理压力和抑郁间的中介变量,拟合指标较好(χ2/df=2.450,GFI=0.942,AGFI=0.941,CFI=0.940,TLI=0.922, RMSEA=0.052,RMR=0.036).结论?心理一致感作为脑卒中患者心理压力与抑郁间的中介变量,使心理压力对抑郁的不良预测效应有所下降.因此应提高脑卒中患者心理一致感,以促进其心理健康,进而减少抑郁症的发生.
更多Objective?To analyze the mediating effects of the sense of coherence between mental stress and depression in stroke patients, and to offer guidance and assistance to reducing mental stress and depression and improving mental health in stroke patients. Methods?Totally 468 stroke patients were selected from the Department of Neurology of a ClassⅢ Grade A hospital in Zhengzhou by convenient sampling between July 2016 and July 2017 and investigated with Sense of Coherence Scale (SOC-13), Chinese Perceived Stress Scale (CPSS) and Center for Epidemiologic Studies Depression Scale (CES-D). The data were statistically analyzed with SPSS 21.0 and AMOS 22.0. Results?The total average scores for SOC-13, CPSS and CES-D in these stroke patients were (63.39±9.92), (41.65±7.29) and (23.80±4.20), respectively. The sense of coherence was negatively correlated with mental stress and depression (r=-0.47,-0.51;P<0.01), and mental stress was positively correlated with depression (r=0.52,P<0.01). As a meditating variable, the sense of coherence reduced the adverse prediction effects of mental stress on depression from 0.632 to 0.283. According to the re-analysis of the structural equation model, the sense of coherence was the mediating variable between mental stress and depression. The fit indexes were good (χ2/df=2.450, GFI=0.942,AGFI=0.941, CFI=0.940, TLI=0.922, RMSEA=0.052, RMR=0.036). Conclusions?As the mediating effect between mental stress and depression, the sense of coherence reduces the adverse prediction effects of mental stress on depression to some extent. Therefore, the sense of coherence in stroke patients shall be enhanced to improve their mental health and reduce the incidence of depression.
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