基本心理需要满足对个人社会资本与维持性血液透析老年患者心理弹性的中介效应-现代医学

基本心理需要满足对个人社会资本与维持性血液透析老年患者心理弹性的中介效应

单位：1. 武汉大学人民医院国际医疗部, 湖北武汉 430060;
2. 中南大学湘雅二医院肾内科血液净化中心, 湖南长沙 4100011;
3. 湖南师范大学医学院护理系, 湖南长沙 410013;
4. 浙江医院护理部, 浙江杭州 310030

关键词：心理弹性基本心理需要满足个人社会资本维持性血液透析

分类号：R395.1

出版年·卷·期（页码）：2023·51·第九期（1285-1291）

摘要：

目的：了解维持性血液透析老年患者心理弹性的现状及影响因素，探究基本心理需要满足对个人社会资本与心理弹性的中介效应。方法：采用随机抽样法，在2021年7至12月使用一般资料调查问卷、个人社会资本问卷、基本心理需要满足量表中文版、心理弹性量表对湖南省623例维持性血液透析老年患者进行调查。采用SPSS 28.0对数据进行分析。结果：维持性血液透析老年患者心理弹性得分为(23.242±8.186)分。分层回归分析显示，相较于60~69岁，≥80岁是维持性血液透析老年患者心理弹性的危险因素(β=-2.408，P=0.020)；相较于小学及以下，高中及以上文化程度是维持性血液透析老年患者心理弹性的保护因素(β=1.860，P=0.013)；个人社会资本和基本心理需要满足均对维持性血液透析老年患者心理弹性具有正向预测作用(β=0.087、4.216，P＜0.001)。中介效应分析显示，个人社会资本不仅能够直接影响维持性血液透析老年患者心理弹性，还能通过基本心理需要满足间接影响心理弹性，其中自主性、信任感和关系性分别占效应值的10.5%、28.2%和8.3%。结论：维持性血液透析老年患者心理弹性处于较低的水平，需要着重关注高龄和低教育水平维持性血液透析老年患者。未来可以通过增加个人社会资本进而提高基本心理需要满足强化维持性血液透析老年患者心理弹性水平。

Objective: To understand the current situation and influencing factors of psychological resilience of elderly patients on maintenance hemodialysis,and to explore the mediating effect of basic psychological needs satisfaction on personal social capital and psychological resilience. Methods: Using a random sampling method,623 elderly patients on maintenance hemodialysis in Hunan Province were surveyed from July to December 2021 using the General Information Questionnaire,the Personal Social Capital Questionnaire,the Chinese version of the Basic Psychological Needs Satisfaction Scale,and the Psychological Resilience Scale. SPSS 28.0 was used to analyze the data. Results: Maintenance hemodialysis elderly patients' psychological resilience score were(23.242±8.186)points. Stratified regression analysis showed that ≥80 years of age was a risk factor for psychological resilience in elderly patients on maintenance hemodialysis compared to 60-69 years of age(β=-2.408, P=0.020); high school and above education degree wor for psycas a protective facthological resilience in elderly patients on maintenance hemodialysis compared to elementary school and below(β=1.860,P=0.013); and both personal social capital and basic psychological needs satisfaction were positive predictors of psychological resilience in elderly patients on maintenance hemodialysis (β=0.087,4.216;P<0.001). Mediated effect analysis showed that personal social capital not only directly influenced psychological resilience in elderly patients on maintenance hemodialysis,but also indirectly influenced psychological resilience through basic psychological needs satisfaction with autonomy,competence and relatedness accounting for 10.5%,28.2% and 8.3% of the effect values,respectively. Conclusion: The psychological resilience of the elderly patients on maintenance hemodialysis showed a low level,and it is necessary to focus on the elderly patients on maintenance hemodialysis with high age and low education degree. In the future,the psychological resilience of maintenance hemodialysis elderly patients can be strengthened by increasing personal social capital and thus improving basic psychological needs satisfaction.

参考文献：

[1] ZHANG L,ZHAO M H,ZUO L,et al.China kidney disease network(CK-NET) 2016 annual data report[J].Kidney Int Suppl,2020,10(2):e97-e185.
[2] EVANS M,LEWIS R D,MORGAN A R,et al.A narrative review of chronic kidney disease in clinical practice:current challenges and future perspectives[J].Adv Ther,2022,39(1):33-43.
[3] THOMAS Z,NOVAK M,PLATAS S G T,et al.Brief mindfulness meditation for depression and anxiety symptoms in patients undergoing hemodialysis:a pilot feasibility study[J].Clin J Am Soc Nephrol,2017,12(12):2008-2015.
[4] TROY A S,WILLROTH E C,SHALLCROSS A J,et al.Psychological resilience:an affect-regulation framework[J].Annu Rev Psychol,2023,74:547-576.
[5] MA L C,CHANG H J,LIU Y M,et al.The relationship between health-promoting behaviors and resilience in patients with chronic kidney disease[J].Sci World J,2013:124973.
[6] MACLEOD S,MUSICH S,HAWKINS K,et al.The impact of resilience among older adults[J].Geriatr Nurs,2016,37(4):266-272.
[7] CHEN X,STANTON B,GONG J,et al.Personal Social Capital Scale:an instrument for health and behavioral research[J].Health Educ Res,2009,24(2):306-317.
[8] DECI E L,RYAN R M.The "what" and "why" of goal pursuits:human needs and the self-determination of behavior[J].Psychol Inq,2000,11(4):227-268.
[9] 吴才智,荣硕,朱芳婷,等.基本心理需要及其满足[J].心理科学进展,2018,26(6):1063-1073.
[10] KU J,AHN D.The relationship among family environment,basic psychological needs,and school engagement of upper elementary school students in Korea[J].Korean J Youth Studies,2015,22(11):21-44.
[11] BALAGUER I,GONZÁLEZ L,FABRA P,et al.Coaches' interpersonal style,basic psychological needs and the well-and ill-being of young soccer players:a longitudinal analysis[J].J Sports Sci,2012,30(15):1619-1629.
[12] VAN DEN BROECK A,VANSTEENKISTE M,DE WITTE H,et al.Explaining the relationships between job characteristics,burnout,and engagement:the role of basic psychological need satisfaction[J].Work & stress,2008,22(3):277-294.
[13] CHIRKOV V,RYAN R M,KIM Y,et al.Differentiating autonomy from individualism and independence:a self-determination theory perspective on internalization of cultural orientations and well-being[J].J Pers Soc Psychol,2003,84(1):97.
[14] 李国强,陈杰,王旭红,等.348例9~16岁城乡结合部青少年家庭社会资本与心理弹性关系[J].中国健康心理学杂志,2018,26(5):753-756.
[15] 李海垒,张文新.心理韧性研究综述[J].山东师范大学学报:人文社会科学版,2006,51(3):149-152.
[16] XUE Y,CHEN F.StatBox:a online statistical computing system[Z].2022
[17] WANG P,CHEN X,GONG J,et al.Reliability and validity of the personal social capital scale 16 and personal social capital scale 8:two short instruments for survey studies[J].Soc Indic Res,2014,119:1133-1148.
[18] CHEN X,STANTON B,GONG J,et al.Personal Social Capital Scale:an instrument for health and behavioral research[J].Health Educ Res,2009,24(2):306-317.
[19] SHELDON K M,NIEMIEC C P.It's not just the amount that counts:balanced need satisfaction also affects well-being[J].J Pers Soc Psychol,2006,91(2):331-341.
[20] 杜健,加藤和生,小林美绪.自我决定理论基本心理需要满足量表中文版在大学生中的信效度检验[J].中国健康心理学杂志,2020,28(2):218-221.
[21] CAMPBELL-SILLS L,STEIN M B.Psychometric analysis and refinement of the Connor-Davidson Resilience Scale(CD-RISC):validation of a 10-item measure of resilience[J].J Trauma Stress,2007,20(6):1019-1028.
[22] CONNOR K M,DAVIDSON J R.Development of a new resilience scale:the Connor-Davidson Resilience Scale(CD-RISC)[J].Depress Anxiety,2003,18(2):76-82.
[23] 叶增杰,阮小丽,曾珍,等.中文版10条目心理韧性量表在护生群体中的信效度分析[J].护理学报,2016,23(21):9-13.
[24] PODSAKOFF P M,MACKENZIE S B,LEE J Y,et al.Common method biases in behavioral research:a critical review of the literature and recommended remedies[J].J Appl Psychol,2003,88(5):879-903.
[25] 刘红,李彦章,张惠,等.社区老年人衰弱与认知功能的关系:心理弹性的中介机制[J].实用老年医学,2022,36(8):842-845.
[26] FLETCHER B R,DAMERY S,AIYEGBUSI O L,et al.Symptom burden and health-related quality of life in chronic kidney disease:a global systematic review and meta-analysis[J].PLoS Med,2022,19(4):e1003954.
[27] PORTZKY M,WAGNILD G,DE BACQUER D,et al.Psychometric evaluation of the Dutch Resilience Scale RS-nl on 3265 healthy participants:a confirmation of the association between age and resilience found with the Swedish version[J].Scand J Caring Sci,2010,24:86-92.
[28] 郭佳钰,侯惠如,吴贞.基于聚类法的老年慢性肾脏病患者照护需求分类研究[J].中华保健医学杂志,2022,24(6):489-491.
[29] 刘学,李国新,张广清,等.220名维持性血液透析患者照顾者心理弹性现状及影响因素分析[J].护理学报,2023,30(8):63-68.
[30] 刘晓宇,陆海英,单亚维,等.全膝关节置换患者术前心理弹性现状及其影响因素分析[J].中华护理杂志,2022,57(17):2102-2108.
[31] 牟鈃雨,赵敏君,马天佩,等.社会支持对我国中老年人共病及其相关结局的影响研究[J].四川大学学报(医学版),2022,53(5):872-879.
[32] 康雄,徐建萍,王国红,等.维持性血液透析病人主观幸福感现状及其影响因素[J].护理研究,2021,35(11):2032-2037.
[33] HOLZ N E,TOST H,MEYER-LINDENBERG A.Resilience and the brain:a key role for regulatory circuits linked to social stress and support[J].Mol Psychiatry,2020,25(2):379-396.
[34] 于海燕,李淑梅,郝桂兰,等.中老年冠心病患者心理弹性在基本心理需要满足与主观幸福感间的中介效应[J].职业与健康,2021,37(11):1510-1514.
[35] HOBFOLL S E.Conservation of resources.A new attempt at conceptualizing stress[J].Am Psychol,1989,44(3):513-524.
[36] 彭顺,牛更枫,汪夏,等.父母自主支持对青少年积极情绪适应的影响:基本心理需要满足的中介与调节作用模型[J].心理发展与教育,2021,37(2):240-248.

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录