心理弹性在老年脑卒中合并功能性便秘患者家庭功能与出院准备度的中介作用

背景便秘是脑卒中常见并发症之一.心理弹性是个体在面对各种压力时所采取的积极措施去处理问题.家庭功能指家庭成员对患者需要的满足,以充分体现家庭的互助互爱,共同承担疾病压力事件的能力.出院准备度是指医务人员根据患者的身体情况整体评估患者是否具备离开医院、回归家庭和自我生活的能力.本研究探讨老年脑卒中便秘患者心理弹性、家庭功能和准备出院度三者的关系,以为临床诊疗提供客观依据.目的旨在探讨心理弹性在老年脑卒中合并慢性功能性便秘患者家庭功能与出院准备度中的中介作用.方法采取便利抽样法,选取2018-10/2019-10在浙江省金华二院收治的老年脑卒中便秘患者120例为调查对象.分别采用家庭关怀指数问卷、心理弹性量表、出院准备度量表调查.结果患者家庭功能总分为7.25分±1.85分,心理弹性总分为54.56分±5.39分,出院准备度总分为88.72分±5.61分.通过Pearson相关性分析表明,患者家庭功能、心理弹性总分及各维度均呈正相关(P<0.05).采用中介效应检验程序,步骤1提示家庭功能对患者出院准备度有正向预测作用(β=0.481,P<0.05);步骤2提示心理弹性对出院准备度有正向预测作用(β=0.494,P<0.05);步骤3加入心理弹性为第3层变量,提示心理弹性对出院准备度有影响(β=0.715,P<0.05),提示心理弹性在家庭功能与出院准备度关系中起部分中介作用,中介效应为0.344(0.715×0.481),占总效应比例为39.03%(0.715×0.481/0.881×100%).结论心理弹性在老年脑卒中合并慢性功能性便秘患者家庭功能与出院准备度中具有中介作用.在临床工作中,医护人员通过提高患者家庭功能和心理弹性,进而提高患者出院准备度.

Mediating effect of mental resilience on family function and discharge readiness in elderly stroke patients with functional constipation

BACKGROUND Constipation is one of the common complications of stroke.Mental resilience refers to the positive measures taken by individuals to deal with problems in the face of various pressures.Family function refers to the ability of family members to meet the needs of patients,fully reflecting the family’s mutual assistance and mutual love,and jointly bear the stressful events of disease.Discharge readiness refers to the ability of the medical staff to evaluate whether the patient is capable of leaving the hospital,returning to the family,and living on his own according to the overall physical condition of the patient.In order to provide an objective basis for clinical diagnosis and treatment,this study explored the relationship among mental resilience,family function,and discharge readiness in elderly patients with stroke and functional constipation.AIM To investigate the mediating effect of mental resilience on family function and discharge readiness in elderly stroke patients with chronic functional constipation.METHODS A total of 120 elderly patients with stroke and functional constipation admitted to the Jinhua Second Hospital of Zhejiang Province from October 2018 to October 2019 were selected by convenient sampling.Family care index questionnaire,mental resilience scale,and discharge readiness scale were used for investigations.RESULTS The total scores of family function,mental resilience,and discharge readiness were 7.25±1.85,54.56±5.39,and 88.72±5.61,respectively.Pearson correlation analysis showed that family function was positively correlated with the total score of mental resilience and the scores of all its dimensions(P<0.05).The test procedure of mediating effect was adopted.Step 1 suggested that family function had a positive predictive effect on patients’discharge readiness(β=0.481,P<0.05).Step 2 suggested that mental resilience had a positive predictive effect on discharge readiness(β=0.494,P<0.05).In step 3,psychological resilience was added as the third level variable,and it was found that psychological resilience had an effect on discharge readiness(β=0.715,P<0.05),suggesting that psychological resilience played an intermediary role in the relationship between family function and discharge readiness.The intermediary effect was 0.344(0.715×0.481),accounting for 39.03%(0.715×0.481/0.881×100%).CONCLUSION Mental resilience plays a mediating role in family function and discharge readiness in elderly stroke patients with chronic functional constipation.In clinical work,the medical staff can improve the patient’s family function and mental resilience,so as to improve the patient’s readiness for discharge.