心理韧性在早期胃癌ESD术后病人自我护理能力与出院准备度间的中介效应

目的了解早期胃癌行内镜黏膜下剥离术(ESD)后病人出院准备度情况，分析心理韧性在自我护理能力与出院准备度间的中介效应。方法选取行ESD手术治疗的早期胃癌病人210例为研究对象，采用一般情况调查表、心理弹性量表、自我护理能力实施量表及出院准备度量表进行问卷调查。分析早期胃癌行ESD术后病人出院准备度与自我护理能力、心理韧性之间的相关关系，并构建结构方程模型，检验心理韧性在早期胃癌行ESD术后病人自我护理能力与出院准备度的中介效应。结果性别、年龄、文化程度、有无照顾者、社会支持程度是早期胃癌行ESD术后病人出院准备度的影响因素(P < 0.01)。早期胃癌ESD术后病人出院准备度总分为(88.55±8.76)分，自我护理能力总分为(97.45±11.83)分，心理韧性总分为(51.98±7.87)分。除适应能力与自我概念间无明显相关关系外(P>0.05)，早期胃癌行ESD术后病人自我护理能力与出院准备度总分及各个维度均呈正相关关系(P < 0.05~P < 0.01)；自我护理能力与心理韧性总分及各个维度均呈正相关关系(P < 0.05~P < 0.01)；出院准备度与心理韧性总分及各个维度均呈正相关关系(P < 0.05~P < 0.01)。心理韧性在出院准备度与自我护理能力间具有42.37%中介作用。结论自我护理能力既能直接正向预测出院准备度，又可以经心理韧性间接预测出院准备度。临床医护人员应重视交流沟通的重要性，促进病人保持积极乐观的心理状态，有助于提升病人的出院准备度水平。

Mediating effect of mental resilience on self-care ability and discharge readiness of patients with early gastric cancer undergoing ESD

ObjectiveTo understand the discharge readiness of patients with early gastric cancer undergoing endoscopic submucosal dissection(ESD), and analyze the mediating effect of mental resilience on self-care ability and discharge readiness.MethodsA total of 210 patients with early gastric cancer undergoing ESD were selected as the research subjects, and surveyed with the general situation questionnaire, psychological resilience scale, self-care ability implementation scale and readiness for hospital discharge scale.The correlations between discharge readiness and self-care ability, mental resilience of patients with early gastric cancer undergoing ESD were analyzed, and the structural equation modeling was constructed to test the mediating effect of mental resilience on the self-care ability and discharge readiness of patients with early gastric cancer undergoing ESD.ResultsGender, age, education level, with caregiver or not, and social support were the influencing factors of discharge readiness of patients with early gastric cancer undergoing ESD(P < 0.01).The total score of discharge readiness of patients with early gastric cancer undergoing ESD was(88.55±8.76) points, the total score of self-care ability was(97.45±11.83) points, and the total score of mental resilience was(51.98±7.87) points.Except that there was no significant correlation between adaptive ability and self-concept(P>0.05), the self-care ability of patients with early gastric cancer undergoing ESD was positively correlated with the total score of discharge readiness and the score of its each dimension(P < 0.05 to P < 0.01);there was a positive correlation between self-care ability and the total score of mental resilience and the score of its each dimension(P < 0.05 to P < 0.01);there was a positive correlation between discharge readiness and the total score of mental resilience and the score of its each dimension(P < 0.05 to P < 0.01).Mental resilience had a 42.37% mediating effect on discharge readiness and self-care ability.ConclusionsSelf-care ability can not only directly and positively predict discharge readiness, but also indirectly predict discharge readiness through mental resilience.Clinical medical staff should pay attention to the importance of communication, promote the patient to maintain a positive and optimistic psychological state, and help to improve the patient's discharge readiness level.