应对方式在脑卒中患者症状群与患者报告结局中的中介效应分析-现代医学

应对方式在脑卒中患者症状群与患者报告结局中的中介效应分析

单位：1. 徐州医科大学附属连云港医院, 江苏连云港 222002;
2. 东南大学医学院, 江苏南京 210009

分类号：R543

出版年·卷·期（页码）：2025·53·第三期（381-392）

摘要：

目的：探讨应对方式在脑卒中患者症状群与患者报告结局(PROs)之间的中介作用，明确3者之间的关系，以改善脑卒中患者的心理健康，提高生活质量。方法：采用便利抽样法，选取455名脑卒中住院患者为研究对象，采用一般资料问卷、脑卒中PROs量表、脑卒中症状体验量表和医学应对方式问卷进行调查。探讨症状群、应对方式与PROs之间的关系，并利用结构方程模型分析应对方式的中介作用。结果： PROs总分与症状群总分呈负相关(r=-0.307，P＜0.01)，与应对方式中的面对呈正相关(r=0.128，P＜0.05)，与回避和屈服均呈负相关(r=-0.238，r=-0.154，均P＜0.05)。平行中介效应分析显示，应对方式中的面对、回避和屈服在症状群对PROs的影响中具有显著中介作用，分别占总效应的25.1%、45.8%和7.2%。结论：应对方式是脑卒中患者症状群与PROs的中介变量，症状群通过3种应对方式对PROs产生的影响具有多样性。未来，护理人员应重视患者症状群，并鼓励积极应对，以提升其生活质量。

Objective: To explore the mediating role of coping strategies between symptom clusters and patient-reported outcomes(PROs) in stroke patients, and to clarify the relationships among these factors in order to improve psychological health and enhance quality of life in stroke patients. Methods: A convenience sampling method was used to select 455 hospitalized stroke patients as the research subjects. Data were collected using a general information questionnaire, the Stroke PROs Scale, the Stroke Symptom Experience Scale, and the Medical Coping Style Questionnaire. The relationships between symptom clusters, coping strategies, and PROs were examined, and structural equation modeling was used to analyze the mediating role of coping strategies. Results: The total score of PROs was negatively correlated with the total score of symptom clusters(r=-0.307, P＜0.01), positively correlated with the confrontation coping strategy(r=0.128, P＜0.05), and negatively correlated with the avoidance and submission coping strategies(r=-0.238, r=-0.154, all P<0.05). Parallel mediation analysis showed that the coping strategies of confrontation, avoidance, and submission significantly mediated the effect of symptom clusters on PROs, accounting for 25.1%, 45.8%, and 7.2% of the total effect, respectively. Conclusion: Coping strategies act as mediators between symptom clusters and PROs in stroke patients, the influence of symptom clusters on PROs through the three coping strategies is diverse. In the future, nursing staff should pay attention to symptom clusters while encouraging positive coping to improve the patients' quality of life.

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