脑卒中后抑郁相关影响因素及其结构模型的研究

目的 探讨生活事件、社会支持和应对方式对脑卒中后抑郁的影响,并建立结构模型.方法 采用生活事件量表、社会支持量表、特质应对方式问卷及汉密尔顿抑郁量表,对125名脑卒中后抑郁患者进行测评,并对结果进行相关、回归及路径分析.结果 生活事件与消极应对、社会支持及抑郁症状呈正相关,与积极应对呈负相关.社会支持与消极应对、积极应对均呈负相关,与抑郁症状呈正相关.抑郁症状与消极应对呈负相关,与积极应对呈正相关.回归分析结果显示：社会支持、生活事件和消极应对是脑卒中后抑郁的影响因素.社会支持和消极应对的介入增强了生活事件对脑卒中后抑郁的影响.该模型的主要拟合指标为：x2/df=2.17 （P=0.008）,GFI=0.983,AGFI=0.954,CFI=0.933,RMSEA=0.053.综合各项拟合指标可以认为所设模型对数据的拟合度良好.结论 生活事件、社会支持、消极应对是脑卒中后抑郁的影响因素,社会支持、消极应对是生活事件与脑卒中抑郁的中介变量.

A study on depression-related factors and structural equation model for post stroke patients

Objective To explore the effects of life event, social support and coping styles on post stroke depression and establish a structural model Methods A total of 125 patients with post stroke depression were assessed according to the Life Event Scale （LES）, the Social Support Scale, the Trait Coping Style and the Hamilton Depression Scale （HAMD）. The data were processed through correlation analysis, stepwise linear regression analysis and path analysis. Results Life event factors were positively related to passive coping style, social support and depression symptoms, but negatively associated with active coping. Social support was negatively related to both active and passive coping styles but positively associated with depression symptoms. Depression symptoms were negatively related to passive coping but posi- tively associated with active coping. Regression analysis showed life event, social support and passive coping could affect post stroke depression. The effects of life event on post stroke depression were enhanced by the introduction of social sup- port and passive coping. A pathway model of social support and passive coping as the mediators of relationship between post stroke depression and life event was established, whose fitting indicators were listed as follows： x2/df = 2.17 （P = 0. 008）, GFI =0. 983, AGFI = O. 954, CFI = O. 933, RMSEA = 0.053. Conclusion Life event, social support and passive coping style exert significant effects on post stroke depression. Social support and passive coping can mediate the relationship between life event and post stroke depression.