应对方式在老年肺炎患者疾病感知与恐惧疾病进展的中介效应分析-现代医学

应对方式在老年肺炎患者疾病感知与恐惧疾病进展的中介效应分析

单位：南京市中心医院老年科, 江苏南京 210000

分类号：R473.5

出版年·卷·期（页码）：2025·53·第三期（449-456）

摘要：

目的：探究应对方式在老年肺炎患者疾病感知与恐惧疾病进展(FoP)之间的中介效应，为临床提高老年肺炎患者心理健康提供参考。方法：采用便利抽样法，纳入2021年1月至2024年1月于本院住院治疗的260例老年肺炎患者。采用一般资料调查问卷、恐惧疾病进展简化量表(FoP-Q-SF)、简易应对方式问卷(SCSQ)、简易疾病感知问卷(BIPQ)对患者进行评估。采用Pearson相关性分析检验疾病感知、应对方式与FoP之间的相关性，并使用Process 3.4软件分析患者积极应对方式在疾病感知、FoP间的中介效应。结果：共回收有效问卷247份，回收率为95.00%。老年肺炎患者FoP-Q-SF评分为(38.45±7.25)分，处于较高水平；SCSQ积极应对、消极应对评分分别为(13.06±3.34)、(16.53±3.88)分，老年肺炎患者更倾向于消极应对；老年肺炎患者BIPQ评分为(40.37±9.31)分，处于一般水平。中介效应分析结果表明，疾病感知通过积极应对方式对FoP产生显著的间接效应(b×c=0.759，95%CI：0.683～0.835)，占疾病感知对FoP总效应的47.56%。结论：老年肺炎患者的疾病感知能够通过积极的应对方式显著影响FoP，其中积极应对方式发挥了重要的中介作用。

Objective: To explore the mediating effect of coping strategies between illness perception and fear of disease progression(FoP) in elderly pneumonia patients, and provide reference for improving the psychological health of elderly pneumonia patients in clinical practice. Methods: Using a convenience sampling method, 260 elderly pneumonia patients hospitalized at our institution from January 2021 to January 2024 were selected. Assessments were conducted using a general information questionnaire, the Fear of Progression Questionnaire-Short Form(FoP-Q-SF), the Simplified Coping Style Questionnaire(SCSQ), and the Brief Illness Perception Questionnaire(BIPQ). Pearson correlation analysis was used to examine the correlations between disease perception, coping strategies and FoP. Additionally, Process 3.4 was used to analyze the mediating effect of positive coping strategies on the relationship between disease perception and FoP. Results: A total of 247 valid questionnaires were collected, with a response rate of 95.00%. The score of FoP-Q-SF was 38.45±7.25, indicating a relatively high level of FoP; the scores of SCSQ for positive and negative coping were 13.06±3.34 and 16.53±3.88, respectively, showing a tendency toward negative coping; the score of BIPQ was 40.37±9.31, reflecting a moderate level of disease perception. The mediating effect results showed that disease perception had a significant indirect effect on FoP through positive coping(b×c=0.759, 95% CI 0.683~0.835), accounting for 47.56% of the total effect of disease perception on FoP. Conclusion: The disease perception of elderly pneumonia patients can significantly influence their FoP through positive coping strategies, with positive coping playing an important mediating role in this process.

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