健康素养对肝硬化代偿期患者生存质量的影响:链式中介模型

目的 探讨肝硬化患者生存质量与健康素养、疾病不确定感和应对方式的关系。方法 采用一般资料调查问卷、慢性肝病问卷、慢性病患者健康素养量表、疾病不确定感成人量表、医学应对方式量表,于2020年1-5月对280例肝硬化代偿期患者进行调查。结果 肝硬化代偿期患者生存质量得分为(84.21±18.01)分,健康素养得分(85.52±18.46)分,疾病不确定感得分(85.06±10.84)分;肝硬化患者健康素养、面对与生存质量呈正相关(r=0.77,P<0.01; r=0.77,P<0.01),疾病不确定感、回避、屈服与生存质量呈负相关(r=-0.88,P<0.01; r=-0.83,P<0.01; r=-0.84,P<0.01)。疾病不确定感和应对方式对生存质量有直接效应,疾病不确定感和应对方式是健康素养影响生存质量的中介变量。结论 肝硬化代偿期患者生存质量和疾病不确定感处于中等水平,健康素养水平较低,护理人员要重视健康素养水平和疾病不确定感及相关因素的影响,引导患者采取积极的应对方式,进而提高生存质量。

Effects of health literacy on life quality of patients with compensatory cirrhosis: A chain-mediated model

Objective To explore the chain-mediated effect of life quality and health literacy, uncertainty of illness and coping style in patients with liver cirrhosis, so as to construct a chain-mediated effect model. Methods Between January and May 2020, 280 patients with liver cirrhosis at decompensation stage were surveyed using a general information questionnaire, chronic liver disease questionnaire, health literacy scale for patients with chronic diseases, adult scale for uncertainty of disease and medical coping style scale. Results The average score of life quality, health literacy and uncertainty of disease were 84.21±18.01, 85.52±18.46 and 85.06±10.84 respectively. The life quality was of negative correlation to the uncertainty of disease, and surrender and avoidance in the coping style(r=0.77,P<0.01; r=0.77,P<0.01), but positive correlation to health literacy and facing in the coping style (r=-0.88,P<0.01; r=-0.83,P<0.01; r=-0.84,P<0.01). Uncertainty of disease and coping style had a direct effect on the life quality, acting as mediating variables of health literacy influencing the life quality. Conclusion The life quality and uncertainty of disease of patients with liver cirrhosis are of a medium level, and their level of health literacy is low. Nursing staff must pay attention to such situation, and guide patients to take positive coping styles,so as to improve their life quality.