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| 首发脑卒中患者主要照顾者社会支持与家庭抗逆力的关系：链式中介模型 |
| 陈丹丹1△,查益1△,王琴1,沙赛1,罗艳蓉2,张瑜3,陈玉盈1,毛赛璐4,于龙娟1* |
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(1. 海军军医大学(第二军医大学)第一附属医院脑血管病中心, 上海 200433;
2. 海军军医大学(第二军医大学)第一附属医院血液内科, 上海 200433;
3. 海军军医大学(第二军医大学)第一附属医院关节骨病外科, 上海 200433;
4. 上海市第十人民医院护理部, 上海 200072
△共同第一作者
*通信作者) |
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| 摘要: |
| 目的 探讨首发脑卒中患者主要照顾者社会支持、积极应对、照护负担、家庭抗逆力之间的关系。方法 采取便利抽样法，选取上海市2家三级甲等医院收治的首发脑卒中患者的主要照顾者307人进行调查研究。采用社会支持评定量表、简易应对方式问卷、Zarit护理负担量表和家庭复原力评定量表进行问卷调查。采用Pearson相关分析和结构方程模型进行数据分析。结果 回收有效问卷288份，有效回收率为93.81%。Pearson相关分析显示，家庭抗逆力与社会支持、家庭抗逆力与积极应对、社会支持与积极应对均呈正相关（r＝0.375、0.627、0.277，均P＜0.01）；照护负担与社会支持、照护负担与积极应对、家庭抗逆力与照护负担均呈负相关（r＝－0.203、－0.343、－0.444，均P＜0.01）。构建以积极应对与照护负担为中介变量、以社会支持为自变量、以家庭抗逆力为因变量的中介效应模型，结果显示社会支持可以通过积极应对对家庭抗逆力起中介作用，中介效应值为0.164，占总效应的26.1%；社会支持也能通过积极应对、照护负担的部分链式中介作用影响首发脑卒中患者主要照顾者的家庭抗逆力，中介效应值为0.032，占总效应的5.1%。结论 在首发脑卒中患者主要照顾者中社会支持能预测家庭抗逆力，并且积极应对与照护负担在社会支持对家庭抗逆力的影响中起链式中介作用。 |
| 关键词: 脑卒中 主要照顾者 社会支持 积极应对 照顾者负担 家庭抗逆力 链式中介效应 |
| DOI：10.16781/j.CN31-2187/R.20250023 |
| 投稿时间：2025-01-10修订日期：2025-03-11 |
| 基金项目:海军军医大学深蓝护理科研项目（2022KYG16），海军军医大学第一附属医院第六期护理科研项目（2025HLCY-A04）. |
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| Relationship between social support and family resilience of primary caregivers of first-stroke patients: a chain mediation model |
| CHEN Dandan1△,ZHA Yi1△,WANG Qin1,SHA Sai1,LUO Yanrong2,ZHANG Yu3,CHEN Yuying1,MAO Sailu4,YU Longjuan1* |
(1. Neurovascular Center, The First Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200433, China;
2. Department of Hematology, The First Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200433, China;
3. Department of Osteoarthropathy, The First Affiliated Hospital of Naval Medical University (Second Military Medical University), Shanghai 200433, China;
4. Department of Nursing, Shanghai Tenth People's Hospital, Shanghai 200072, China
△Co-first authors.
* Corresponding author) |
| Abstract: |
| Objective To explore the relationships between social support, positive coping, caregiver burden and family resilience of primary caregivers of first-stroke patients. Methods A questionnaire survey was conducted among 307 primary caregivers of first-stroke patients in 2 tertiary hospitals in Shanghai by convenience sampling method. Social support rating scale, simplified coping style questionnaire, Zarit caregiver burden interview, and family resilience assessment scale were used for questionnaire survey. Pearson correlation analysis and structural equation models were used for data analysis. Results A total of 288 valid questionnaires were collected, and the effective recovery rate was 93.81%. Pearson correlation analysis showed that there was a positive correlation between family resilience and social support, family resilience and positive coping, and social support and positive coping (r＝0.375, 0.627, and 0.277; all P＜0.01), while caregiver burden and social support, caregiver burden and positive coping, and family resilience and caregiver burden were all negatively correlated (r＝－0.203, －0.343, and －0.444; all P＜0.01). The mediating effect model was constructed with positive coping and caregiver burden as mediating variables, social support as independent variables, and family resilience as dependent variables. The results showed that social support could mediate family resilience through positive coping, with a mediating effect of 0.164, accounting for 26.1% of the total effect; social support could also affect the family resilience of the primary caregivers of first-stroke patients through the partial chain mediating effect of positive coping and caregiver burden, with a mediating effect value of 0.032, accounting for 5.1% of the total effect. Conclusion Social support can predict family resilience among primary caregivers of first-stroke patients, and positive coping and caregiver burden play chain mediating roles in the impact of social support on family resilience. |
| Key words: stroke primary caregivers social support positive coping caregiver burden family resilience chain mediating effects |
