家庭功能在初发脑卒中后抑郁病人病耻感与不良情绪间的中介作用分析

目的 探讨家庭功能在初发脑卒中后抑郁（PSD）病人病耻感与不良情绪间的中介作用，为促进PSD病人身心健康提供临床依据。方法 选取2019年1月至2021年5月在石家庄市妇幼保健院收治的231例初发PSD病人作为研究对象，采用激惹、抑郁和焦虑自评量表（IDA）、脑卒中病人病耻感量表（SSS）及家庭功能评价量表（APGAR）评估研究对象不良情绪、病耻感及家庭功能状况，并采用Pearson法分析三者间的相关性，结构方程模型进一步检验家庭功能在病耻感与负性情绪间的中介效应。结果 初发PSD病人IDA评分（62.32±5.85）分，SSS评分（57.69±4.10）分，APGAR评分（4.56±2.10）分；Pearson相关性分析得知，PSD病人APGAR评分与SSS评分呈负相关（r=-0.44,P<0.001），与IDA评分呈负相关（r=-0.49,P<0.001）,SSS评分与IDA评分呈正相关（r=0.47,P<0.001）；中介模型提示，家庭功能在病耻感与不良情绪间起中介作用（β=0.36,P<0.001）。本研究中，间接效应>直接效应，中介效应占总效应的...

Analysis of the role of family functioning in mediating the relationship between stigma and dysphoria in depressed patients after initial stroke

Objective To investigate the mediating role of family functioning between stigma and dysphoria in patients with primary post-stroke depression (PSD), and to provide a clinical basis for promoting physical and mental health in patients with PSD.Methods Two hundred and thirty-one patients with first-onset PSD admitted to Shijiazhuang Maternal and Child Health Hospital from January2019 and May 2021 were selected as study subjects, and the Self-Rating Inventory of Irritation, Depression and Anxiety (IDA), the Sick.ness Stigma Scale for Stroke Patients (SSS) and the Assessment of Family Functioning Scale (APGAR) were used to assess the status ofdysphoria, sickness stigma and family functioning in the study subjects, and the Pearson method was used to analyze the correlation be.tween the three, and structural equation modeling was used to further test the mediating effect of family functioning between sicknessstigma and negative emotions.Results IDA score, SSS score and APGAR score in patients with first-onset PSD were (62.32±5.85),(57.69±4.10), (4.56±2.10), respectively. Pearson correlation analysis revealed that APGAR scores of PSD patients were negatively cor.related with SSS scores (r=.0.44, P<0.001), negatively correlated with IDA scores (r=.0.49, P<0.001), and SSS scores were positively correlated with IDA scores (r=0.47, P<0.001). The mediation model suggested that family functioning mediated the relationship be.tween morbidity stigma and dysphoria (β=0.36, P<0.001). In this study, the indirect effect was greater than the direct effect, and the ra.tio of the mediating effect to the total effect was (.0.662) × (.0.538)/0.462=77.09%.Conclusions The morbid stigma of patients with first-onset PSD can directly predict the bad mood, but family function can play a mediating moderating effect to correct the bad moodand reduce the morbid stigma. Therefore, family support should be given to patients with first-onset PSD adequately to promote their healthy physical and mental development in clinical work.