抑郁在老年骨质疏松性髋部骨折术后患者自我效能感和生活质量之间的中介作用
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摘要
目的探讨老年骨质疏松性髋部骨折术后患者抑郁、自我效能感和生活质量的关系,以及抑郁在自我效能感和生活质量间的中介作用。方法采用整群随机抽样法,选取哈尔滨市2所三级甲等综合医院收治的300例老年骨质疏松性髋部骨折术后患者为研究对象,采用贝克抑郁量表第2版、一般自我效能感量表、世界卫生组织生存质量测定简表进行问卷调查。结果患者自我效能感和生活质量各领域得分呈正相关(r=0.281～0.605,P<0.01)、患者抑郁与自我效能感和生活质量各领域得分呈负相关(r=-0.372～-0.255,P<0.01);抑郁在自我效能感和生理领域、心理领域、社会关系领域、环境领域之间具有部分中介作用。结论老年骨质疏松性髋部骨折术后患者有轻度抑郁情绪,患者自我效能感和生活质量都较差,抑郁在自我效能感和生活质量各领域之间具有部分中介作用,应制订相应的干预措施提高自我效能感,降低患者的抑郁情绪,从而提高患者的生活质量。
Objective To explore the relationship between depression, self-efficacy and quality of life in elderly patients with osteoporotic hip fracture,and the mediating effect of depression on self-efficacy and quality of life.Methods The group randomized sampling method was used to select 300 elderly patients with osteoporotic hip fractures from 2 3A-level general hospitals in Harbin.The Second Edition of The Beck Depression Inventory,General Self-efficacy Scale,World Health Organization on Quality of Life Brief Scale(WHOQOL-BREF)were used for the survey.Results There was a positive correlation between the patient's general self-efficacy and areas of quality of life scores(r= 0.281～0.605,P<0.01).There was a negative correlation among the patient's depression and self-efficacy and areas of quality of life scores(r=-0.372～-0.255,P<0.01).Depression played a part of the mediating effect between self-efficacy and quality of life in the physical field,the psychological field,the social relations field and the environmental field.Conclusion Elder patients with osteoporotic hip fracture surgery have mild depression,patients with poor self-efficacy and quality of life,depression could mediate the relationship between self-efficacy and quality of life.The corresponding intervention measures should be formulated to improve the self-efficacy,reduce the depression of the patient,and thus improve the quality of life of the patient.
Objective To explore the relationship between depression, self-efficacy and quality of life in elderly patients with osteoporotic hip fracture,and the mediating effect of depression on self-efficacy and quality of life.Methods The group randomized sampling method was used to select 300 elderly patients with osteoporotic hip fractures from 2 3A-level general hospitals in Harbin.The Second Edition of The Beck Depression Inventory,General Self-efficacy Scale,World Health Organization on Quality of Life Brief Scale(WHOQOL-BREF)were used for the survey.Results There was a positive correlation between the patient's general self-efficacy and areas of quality of life scores(r= 0.281～0.605,P<0.01).There was a negative correlation among the patient's depression and self-efficacy and areas of quality of life scores(r=-0.372～-0.255,P<0.01).Depression played a part of the mediating effect between self-efficacy and quality of life in the physical field,the psychological field,the social relations field and the environmental field.Conclusion Elder patients with osteoporotic hip fracture surgery have mild depression,patients with poor self-efficacy and quality of life,depression could mediate the relationship between self-efficacy and quality of life.The corresponding intervention measures should be formulated to improve the self-efficacy,reduce the depression of the patient,and thus improve the quality of life of the patient.
引文
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[8]柏燕,丁文鸽.Clark安适护理干预模式对骨质疏松症患者自我效能、负性情绪及生活质量的影响[J].临床护理杂志,2017,16(5):2-4.DOI:10.3969/j.issn.1671-8933.2017.05.001.
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[11]王振,苑成梅,黄佳,等.贝克抑郁量表第2版中文版在抑郁症患者中的信效度[J].中国心理卫生杂志,2011,25(6):476-480. DOI:10.3969/j. issn.1000-6729.2011.06.014.
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[17]薄海欣,陈洁.正念减压疗法对不孕症患者焦虑抑郁水平及生活质量的影响[J].护理管理杂志,2017,17(4):274-276.
[18]钱会娟,周玲,孙雅妮,等.股骨头坏死患者延迟就医行为、疾病认知及自我效能感现状调查[J].解放军护理杂志,2016,33(22):12-16. DOI:10.3969/j. issn.1008-9993.2016.22.003.
[19]蔡建丽,杨碧燕,杨燕,等.老年髋部骨折患者自我效能影响因素研究[J].护理实践与研究,2010,7(5):4-5.
[20]靳剑峰,范燕华,张彦平,等.疾病不确定感理论在慢性病护理领域的研究现状[J].全科护理,2016,14(21):2179-2181.DOI:10.3969/j.issn.1674-4748.2016.21.007.
[21]许来霞.骨质疏松性髋部骨折术后患者心理弹性与生活质量的相关性[J].当代护士,2017(11A):49-51.DOI:10.3969/j.issn.1006-6411.2017.11.025.
[22]贺金亮,夏群,刘恺.老年髋部骨质疏松性骨折患者生活质量的调查[J].医学研究杂志,2012,41(9):126-128.DOI:10.3969/j.issn.1673-548X.2012.09.041.
[23]丁庆彬,李艳双,吴怀兰,等.骨质疏松性椎体压缩性骨折术后老年患者生活质量及其影响因素研究[J].护理管理杂志, 2018, 18(2):77-80. DOI:10. 3969/j. issn.1671-315x.2018.02.001.
[24]余安汇,王维利,洪静芳,等.临床护士自我效能感与焦虑、抑郁的相关性研究[J].护理学报,2011,18(10):1-4.DOI:10.3969/j.issn.1008-9969.2011.10.001.
[25]陈玉梅,闫树英,赵丽丽,等.高龄胃癌患者自我效能感与生活质量、社会支持及焦虑抑郁的相关性[J].中国老年学杂志,2017,37(9):2288-2290.DOI:10.3969/j.issn.1005-9202.2017.09.098.
[26]李全兵,郭建兵,李贺斌,等.女性抑郁与社会支持及生活质量的相关性研究[J].贵州医药,2017,41(2):205-206.DOI:10.3969/j.issn.1000-744X.2017.02.044.
[27]邓云龙,阳中华,陈向一.社会支持和家庭功能与老年人主观幸福感的相关性[J].中国老年学杂志, 2012,32(16):3501-3503. DOI:10. 3969/j. issn. 1005-9202.2012.16.072.
[2]白璧辉,谢兴文,李鼎鹏,等.我国近5年来骨质疏松症流行病学研究现状[J].中国骨质疏松杂志,2018,24(2):253-258.DOI:10.3969/j.issn.1006-7108.2018.02.024.
[3]李洪秋,阿良,赵忠海,等.沈阳地区老年髋部骨质疏松性骨折流行病学调查分析[J].中国骨质疏松杂志,2013,19(3):293-296.DOI:10.3969/j.issn.1006-7108.2013.03.023.
[4]杨萍,路潜,王晓丹,等.老年髋部骨折术后患者抑郁及康复状况的研究[J].护理管理杂志,2012,12(3):175-177.
[5]SHYU Y I,CHENG H S,TENG H C,et al.Older peoplewith hip fracture:depression in the postoperative firstyear[J]. Journal of Advanced Nursing, 2009, 65(12):2514-2522.
[6]韩京媛.老年髋部骨折患者心理特征对早期康复锻炼依从性的影响[J].护理管理杂志,2009,9(8):8-9.
[7]彭文芳,赵文穗.绝经后患者焦虑、抑郁状态对骨质疏松和生活质量的影响[J].中国骨质疏松杂志, 2007,13(9):642-644.DOI:10.3969/j.issn.1006-7108.2007.09.010.
[8]柏燕,丁文鸽.Clark安适护理干预模式对骨质疏松症患者自我效能、负性情绪及生活质量的影响[J].临床护理杂志,2017,16(5):2-4.DOI:10.3969/j.issn.1671-8933.2017.05.001.
[9]刘印.社区老年人一般自我效能感与生活质量的相关性[J].中国老年学杂志,2013,33(6):1367-1368.DOI:10.3969/j.issn.1005-9202.2013.06.062.
[10]季艳萍,杨艳杰.应对方式在老年骨质疏松性髋部骨折术后患者自我效能感和生存质量之间的中介效应[J].护理管理杂志,2015,15(10):692-695.
[11]王振,苑成梅,黄佳,等.贝克抑郁量表第2版中文版在抑郁症患者中的信效度[J].中国心理卫生杂志,2011,25(6):476-480. DOI:10.3969/j. issn.1000-6729.2011.06.014.
[12]张作记.行为医学量表手册[M].北京:中华医学电子音像出版社,2005:187-188.
[13]郝元涛,方积乾.世界卫生组织生存质量测定量表中文版介绍及其使用说明[J].现代康复, 2000, 4(8):1127-1129. DOI:10. 3321/j. issn:1673-8225. 2000. 08.002.
[14]方积乾.生存质量测定方法及应用[M].北京:北京医科大学出版社,2000:118.
[15]孙振华.老年髋部骨折患者抑郁焦虑情绪原因分析及心理干预[J].齐鲁护理杂志,2012,18(22):12-14.DOI:10.3969/j.issn.1006-7256.2012.22.007.
[16]葛向煜,王君俏,刘邦忠,等.老年髋部骨折患者术后抑郁水平追踪调查[J].护理研究,2009,23(1):17-19.DOI:10.3969/j.issn.1009-6493.2009.01.0060.
[17]薄海欣,陈洁.正念减压疗法对不孕症患者焦虑抑郁水平及生活质量的影响[J].护理管理杂志,2017,17(4):274-276.
[18]钱会娟,周玲,孙雅妮,等.股骨头坏死患者延迟就医行为、疾病认知及自我效能感现状调查[J].解放军护理杂志,2016,33(22):12-16. DOI:10.3969/j. issn.1008-9993.2016.22.003.
[19]蔡建丽,杨碧燕,杨燕,等.老年髋部骨折患者自我效能影响因素研究[J].护理实践与研究,2010,7(5):4-5.
[20]靳剑峰,范燕华,张彦平,等.疾病不确定感理论在慢性病护理领域的研究现状[J].全科护理,2016,14(21):2179-2181.DOI:10.3969/j.issn.1674-4748.2016.21.007.
[21]许来霞.骨质疏松性髋部骨折术后患者心理弹性与生活质量的相关性[J].当代护士,2017(11A):49-51.DOI:10.3969/j.issn.1006-6411.2017.11.025.
[22]贺金亮,夏群,刘恺.老年髋部骨质疏松性骨折患者生活质量的调查[J].医学研究杂志,2012,41(9):126-128.DOI:10.3969/j.issn.1673-548X.2012.09.041.
[23]丁庆彬,李艳双,吴怀兰,等.骨质疏松性椎体压缩性骨折术后老年患者生活质量及其影响因素研究[J].护理管理杂志, 2018, 18(2):77-80. DOI:10. 3969/j. issn.1671-315x.2018.02.001.
[24]余安汇,王维利,洪静芳,等.临床护士自我效能感与焦虑、抑郁的相关性研究[J].护理学报,2011,18(10):1-4.DOI:10.3969/j.issn.1008-9969.2011.10.001.
[25]陈玉梅,闫树英,赵丽丽,等.高龄胃癌患者自我效能感与生活质量、社会支持及焦虑抑郁的相关性[J].中国老年学杂志,2017,37(9):2288-2290.DOI:10.3969/j.issn.1005-9202.2017.09.098.
[26]李全兵,郭建兵,李贺斌,等.女性抑郁与社会支持及生活质量的相关性研究[J].贵州医药,2017,41(2):205-206.DOI:10.3969/j.issn.1000-744X.2017.02.044.
[27]邓云龙,阳中华,陈向一.社会支持和家庭功能与老年人主观幸福感的相关性[J].中国老年学杂志, 2012,32(16):3501-3503. DOI:10. 3969/j. issn. 1005-9202.2012.16.072.