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中华疝和腹壁外科杂志(电子版) ›› 2023, Vol. 17 ›› Issue (04) : 468 -472. doi: 10.3877/cma.j.issn.1674-392X.2023.04.022

论著

护理能力与应对方式在造口患者造口影响与生活质量间的中介效应
王静, 庞冬(), 高赫, 刘金   
  1. 100044 北京大学人民医院
    100191 北京大学护理学院
    010055 呼和浩特,内蒙古自治区卫生健康委员会
    100034 北京大学第一医院普通外科
  • 收稿日期:2022-08-29 出版日期:2023-08-18
  • 通信作者: 庞冬

Mediating effects of nursing ability and coping strategies on the relationship between stoma impact and quality of life in patients with ostomy

Jing Wang, Dong Pang(), He Gao, Jin Liu   

  1. Peking University People's Hospital, Beijing 100044, China
    Peking University School of Nursing, Beijing 100191, China
    Inner Mongolia Autonomous Region Health Commission, Hohhot 010055, China
    Stoma Clinic of General Surgery, Peking University First Hospital, Beijing 100034, China
  • Received:2022-08-29 Published:2023-08-18
  • Corresponding author: Dong Pang
引用本文:

王静, 庞冬, 高赫, 刘金. 护理能力与应对方式在造口患者造口影响与生活质量间的中介效应[J/OL]. 中华疝和腹壁外科杂志(电子版), 2023, 17(04): 468-472.

Jing Wang, Dong Pang, He Gao, Jin Liu. Mediating effects of nursing ability and coping strategies on the relationship between stoma impact and quality of life in patients with ostomy[J/OL]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2023, 17(04): 468-472.

目的

通过构建结构方程模型探讨自我护理能力与应对方式在永久性结肠造口患者造口影响与生活质量间的中介效应。

方法

2019年3—9月,于北京市两家综合性三级甲等医院采用邮寄问卷联合造口门诊对218例永久性结肠造口患者进行问卷调查,问卷包括一般资料问卷、造口影响评分、医学应对量表、自我护理能力测定量表、欧洲癌症研究和治疗组织生活质量核心问卷(QLQ-C30)。

结果

造口影响对生活质量具有负向作用,总效应为-0.474,直接效应为-0.261,间接效应为-0.213。面对应对方式在造口影响与生活质量之间起到正向中介作用,中介效应占总效应的6.3%(0.030/0.474)。自我护理能力在造口影响与生活质量之间起到负向中介作用,中介效应占总效应的51.2%(0.243/0.474)。

结论

造口影响与生活质量之间存在负相关关系,自我护理能力与面对应对方式在造口影响和生活质量之间起到部分中介作用,其中自我护理能力的中介效应更显著。

Objective

To investigate the mediating effects of self-care ability and coping strategies on the relationship between stoma impact and quality of life in patients with permanent colostomies using a structural equation model.

Methods

From March to September 2019, 218 patients with permanent colostomy were investigated in two Grade A hospitals in Beijing by mail questionnaire and ostomy clinic. The questionnaires included a general demographic questionnaire, a stoma impact rating, a medical coping scale, a self-care ability measure, and the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire (QLQ-C30).

Results

The stoma impact had a negative effect on the quality of life, with a total effect of -0.474, a direct effect of -0.261, and an indirect effect of -0.213. The coping strategy acted as a positive mediator between stoma impact and quality of life, accounting for 6.3% (0.030/0.474) of the total effect. The ability to self-care acted as a negative mediator between stoma impact and quality of life, accounting for 51.2% (0.243/0.474) of the total effect.

Conclusion

There is a negative correlation between stoma impact and quality of life. Both self-care ability and coping strategies play a partial mediating role between stoma impact and quality of life, with the mediating effect of self-care ability being more pronounced.

表1 造口影响、自我护理能力、医学应对方式、生活质量之间相关性分析(n=218)
图1 造口影响、自我护理能力、医学应对方式、生活质量最终模型路径分析结果注:P<0.01,P<0.001。
表2 造口影响、自我护理能力、医学应对方式、生活质量之间的关系最终模型拟合指数
表3 造口影响、自我护理能力、医学应对方式、生活质量之间关系的效应值及总效应(n=218)
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