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| 心理弹性在中青年冠心病患者及配偶二元应对与创伤后成长中的中介作用 |
| The mediating role of resilience in dyadic coping and post-traumatic growth in young and middle-aged patients with coronary heart disease and their spouses |
| 投稿时间：2024-10-14 修订日期：2024-12-30 |
| DOI： |
| 中文关键词: 冠心病；二元应对；心理弹性；创伤后成长 |
| 英文关键词: Coronary Heart Disease, Dyadic Coping; Resilience; Post-traumatic Growth |
| 基金项目:济宁市重点研发计划(2023JNZC028) |
| 作者 | 单位 | 邮编 | | 郭丽红 | 山东第一医科大学护理学院 | 250117 | | 崔倩 | 济宁医学院附属医院心内科 | | | 任丽萍 | 山东第二医科大学护理学院 | | | 孙丹丹 | 济宁医学院附属医院心内科 | | | 王文青 | 济宁医学院附属医院心内科 | | | 薛靖 | 济宁医学院附属医院心内科 | | | 郭丽 | 济宁医学院附属医院心内科 | | | 尚苗苗 | 济宁医学院附属医院心内科 | | | 李祥廷 | 济宁医学院附属医院心内科 | | | 李伟* | 济宁医学院附属医院护理部 | 272001 |
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| 中文摘要: |
| 目的：探讨心理弹性在中青年冠心病患者及配偶二元应对和与创伤后成长中的中介作用。 方法：选取中青年冠心病患者及配偶267对，采用中文版二元应对问卷、心理弹性量表、简体中文版创伤后成长评定量表分别评估患者及配偶的二元应对、心理弹性、创伤后成长，通过主客体互倚中介模型分析心理弹性的中介效应。 结果：模型显示，患者及配偶自身二元应对、心理弹性对自身创伤后成长具有主体效应（β=0.193，P＜0.001；β=0.598，P＜0.001），患者及配偶自身的二元应对对自身心理弹性得分同样具有主体效应（β=0.376，P＜0.001）。自身二元应对对配偶心理弹性存在客体效应（β=0.160，P＜0.001），自身心理弹性对配偶创伤后成长存在客体效应（β=0.125，P=0.003）。患者及配偶的心理弹性在自身二元应对和自身创伤后成长中具有部分中介效应，效应值为0.245（95%CI=0.190~0.316），占总效应比例55.9%。患者及配偶的心理弹性在自身二元应对和配偶创伤后成长具有完全中介效应，效应值为0.143（95%CI=0.093~0.191），占总效应的82.2%。结论：医护人员应将中青年冠心病患者及配偶视为一个共同体，制订以夫妻为中心的相互支持应对策略，从而增加其心理弹性，进而提高二者创伤后成长的水平。 |
| 英文摘要: |
| Objective: To explore the mediating role of resilience in the dyadic coping and post-traumatic growth of young and middle-aged patients with coronary heart disease and their spouses. Methods: 267 pairs of young and middle-aged patients with coronary heart disease and their spouses were selected to evaluate the dyadic coping, resilience and post-traumatic growth of the patients and their spouses using the Dyadic Coping Inventory, the Connor-Davidson Resilience Scale and the Chinese-Posttraumatic Growth Inventory respectively. The mediating effect of resilience was analyzed by subject-object interdependence mediation model. Results: The model showed that dyadic coping and resilience of patients and spouses had a major effect on their own post-traumatic growth (β=0.193, P < 0.001; β=0.598, P < 0.001), the dyadic coping of patients and their spouses also had a subjective effect on their own psychological resilience scores (β=0.376, P < 0.001). There was object effect on spouse's resilience (β=0.160, P < 0.001), and object effect on spouse's post-traumatic growth (β=0.125, P=0.003). The resilience of patients and their spouses had a partial mediating effect on self-dyadicy coping and self-post-traumatic growth, with an effect value of 0.245 (95%CI=0.190~0.316), accounting for 55.9% of the total effect. The resilience of patients and their spouses had a complete mediating effect on self-dyadic coping and spousal post-traumatic growth, with an effect value of 0.143 (95%CI=0.093~0.191), accounting for 82.2% of the total effect. Conclusion: Medical staff should treat young and middle-aged patients with coronary heart disease and their spouses as a community, and formulate mutual support coping strategies centered on husband and wife, so as to increase their resilience and improve their level of post-traumatic growth. |
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