颅内动脉瘤血管造影患者疾病感知对恐惧疾病进展的影响路径分析：家庭功能的中介作用-现代医学

颅内动脉瘤血管造影患者疾病感知对恐惧疾病进展的影响路径分析：家庭功能的中介作用

作者：万小惠¹ 刘娜娜² 戴玉凤³ 王笑华⁴ 徐文璇⁵ 罗敏¹ 章佳佳¹ 谢安明¹

单位：1. 中国人民解放军联勤保障部队第九O八医院放射诊断科, 江西南昌 330002;
2. 中国人民解放军联勤保障部队第九O八医院护理部, 江西南昌 330002;
3. 中国人民解放军联勤保障部队第九O八医院妇产科, 江西南昌 330002;
4. 中国人民解放军联勤保障部队第九O八医院

关键词：颅内动脉瘤血管造影恐惧疾病进展疾病感知家庭功能中介效应

分类号：R543

出版年·卷·期（页码）：2026·45·第四期（582-590）

摘要：

目的： 基于疾病感知理论构建结构方程模型，系统探究颅内动脉瘤血管造影患者疾病感知对恐惧疾病进展的影响路径，并重点验证家庭功能在二者间的中介效应。方法： 选取2023年1月至2025年9月在本院行数字减影血管造影(DSA)的疑似颅内动脉瘤患者201例进行横断面调查。DSA检查前，采用疾病感知量表(BIPQ)、家庭关怀度指数问卷(APGAR)、恐惧疾病进展简化量表(FoP-Q-SF)对患者进行调查。应用AMOS软件构建结构方程模型，分析患者疾病感知对恐惧疾病进展的影响路径以及家庭功能在其中的中介作用。结果： 颅内动脉瘤血管造影患者的FoP-Q-SF的平均得分为(31.82±4.61)分，其中生理健康维度(18.67±2.85)分，社会家庭维度(13.23±5.29)分。患者的疾病感知对恐惧疾病进展有正面影响(B=2.306，95%CI 0.228～4.263，P<0.05)、疾病感知对家庭功能有负面影响(B=-0.743，95%CI -0.934～-0.601，P<0.05)、家庭功能对恐惧疾病进展有负面影响(B=-2.629，95%CI -5.404～-0.105，P<0.05)。调整蛛网膜下腔出血史等混杂因素后，中介效应具有统计学意义(B=1.954，95%CI 0.077～3.896，P<0.05)，疾病感知对恐惧疾病进展的总效应显著(B=4.260，95%CI 3.444～5.109，P<0.05)。结论： 颅内动脉瘤血管造影患者的疾病感知、家庭功能与恐惧疾病进展之间存在显著关联，疾病感知不仅可直接加剧恐惧情绪，还可通过削弱家庭功能间接升高恐惧水平，家庭功能在路径中发挥部分中介作用。基层医护人员应在诊断等待期同步评估患者认知与家庭支持，以低成本沟通干预纠正灾难化认知、激活家庭情感资源，从而缓冲疾病不确定感。

Objective: To construct a structural equation model based on illness-perception theory to systematically explore the impact pathways of illness perception on fear of progression in patients with intracranial aneurysm undergoing angiography, with a particular focus on validating the mediating effect of family functioning. Methods: A total of 201 patients with suspected intracranial aneurysms who underwent digital subtraction angiography(DSA) in our hospital from January 2023 to September 2025 were enrolled in this cross-sectional survey. Before DSA examination, the brief illness perception questionnaire(BIPQ), Family APGAR Index, and fear of progression questionnaire-short form(FoP-Q-SF) were administered. Amos software was used to build a structural-equation model to analyze the pathways from illness perception to fear of progression and to examine the mediating role of family functioning. Results: The mean FoP-Q-SF score of the intracranial aneurysm angiography patients was(31.82±4.61), with the physical-health dimension(18.67±2.85) and the social-family dimension(13.23±5.29). Illness perception exerted a positive effect on fear of progression(B=2.306, 95%CI 0.228-4.263, P<0.05), a negative effect on family functioning(B=-0.743, 95%CI -0.934- -0.601, P<0.05), and family functioning had a negative effect on fear of progression(B=-2.629, 95%CI -5.404- -0.105, P<0.05). After adjusting for confounding factors(history of subarachnoid hemorrhage), the mediating effect was statistically significant(B=1.954, 95%CI 0.077-3.896,P<0.05), and the total effect of illness perception on fear of progression was significant(B=4.260,95%CI 3.444-5.109, P<0.05). Conclusion: Illness perception, family functioning and fear of progression are significantly inter-related in intracranial aneurysm angiography patients. Illness perception not only directly intensifies fear but also indirectly elevates fear by weakening family functioning; family functioning thus exerts a partial mediating effect. Primary-level clinicians should simultaneously assess patients' cognition and family support during the diagnostic waiting period, and apply low-cost communication interventions to correct catastrophic cognitions and mobilize family emotional resources so as to buffer illness-related uncertainty.

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