配偶照顾负担对脑卒中偏瘫患者二元应对及配偶二元应对的中介作用

目的 调查脑卒中偏瘫患者二元应对水平、配偶二元应对水平以及配偶照顾负担的得分状况,探讨配偶照顾负担对脑卒中偏瘫患者二元应对与配偶二元应对的中介作用。方法 选取311对住院的脑卒中偏瘫患者及其配偶,采用一般资料调查表,二元应对量表(DCI) ,照顾者负担量表(ZBI)进行问卷调查。分析配偶照顾负担在脑卒中偏瘫患者二元应对和配偶二元应对之间的中介效应。结果 脑卒中偏瘫患者二元应对得分为(100.05±19.02)分,配偶二元应对得分为(86.03±16.62)分,配偶照顾负担得分为(59.49±13.90)分。配偶照顾负担与患者二元应对、配偶二元应对均呈负相关( r =－0. 719、r =－0. 790,P＜0. 001),患者二元应对与配偶二元应对呈正相关( r = 0. 840,P＜0. 001)。模型拟合结果显示,配偶照顾负担在脑卒中偏瘫患者二元应对及其配偶二元应对之间起中介作用( β =0.264,P＜0. 001),占总效应的30.14%。结论 脑卒中偏瘫患者二元应对多数处于低水平,脑卒中偏瘫患者二元应对对配偶二元应对有直接预测作用,但受到照顾者负担的中介效应调节,今后可制定针对降低照顾者负担的护理干预措施,以提高患者及配偶的二元应对水平,促进其心理健康。

The mediating effect of spouse care burden on dual coping and spouse dual copingin stroke patients with hemiplegia

Objective To investigate the scores of dual coping level, spouse dual coping level and spouse care burden in stroke patients with hemiplegia, and to explore the mediating effect of spouse care burden on dual coping and spouse dual coping in stroke patients with hemiplegia.Methods A total of 311 hospitalized stroke patients with hemiplegia and their spouses were selected for questionnaire survey using general data questionnaire, bivariate Coping scale (DCI) and caregiver Burden Scale (ZBI). To analyze the mediating effect of spouse care burden on dual coping and spouse dual coping in stroke patients with hemiplegia.Results The score of dyadic coping of stroke patients with hemiplegia was (100.05±19.02), the score of spouse dyadic coping was (86.03±16.62), and the score of spouse care burden was (59.49±13.90). The burden of spouse care was negatively correlated with patients" dyadic coping and spouse"s dyadic coping (r = -0.719, r = -0.790, P < 0.001), while patients" dyadic coping was positively correlated with spouse"s dyadic coping (r = 0.840, P < 0.001). The results of model fitting showed that spouse care burden played a mediating role between dyadic coping and dyadic coping of stroke patients with hemiplegia (β=0.264, P<0. 001).Conclusion dual response to most stroke patients with hemiplegia at a lower level, stroke patients with hemiplegia binary response to spouse binary has direct prediction effect, but the intermediary effect to adjust by the caregiver burden, the future can be formulated according to reduce the burden of caregivers of nursing intervention measures, to improve the level of the patient and spouse binary response, promote their psychological health.