自我效能感在慢性阻塞性肺疾病患者疾病反刍思维与心理健康相关生命质量间的中介效应OA
Self-efficacy as a mediator between patient's rumination on disease and their psychological health-related quality of life in patients with chronic obstructive pulmonary disease
目的:探讨慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者疾病反刍思维对其心理健康相关生命质量的影响,并检验自我效能感在二者间的中介作用.方法:采用便利抽样法,参照入组标准选取2023年6月至2025年10月期间上海市第二人民医院收治的263例COPD患者作为研究对象.使用一般资料调查表、一般自我效能量表、反刍思维量表及12项简短健康调查问卷(SF-12)对所有研究对象进行问卷调查,并计算相应得分.采用SPSS 21.0软件对自我效能感、疾病反刍思维、心理健康相关生命质量进行Spearman相关性分析,使用Amos 28.0软件构建结构方程模型并检验自我效能感的中介效应.结果:COPD患者自我效能感、疾病反刍思维和心理健康相关生命质量的得分分别为(23.42±5.51)分、(54.65±6.84)分、(62.71±8.78)分.Spearman相关性分析显示,自我效能感与疾病反刍思维呈显著负相关(r=-0.798,P＜0.001),与心理健康相关生命质量呈显著正相关(r=0.859,P＜0.001);疾病反刍思维与心理健康相关生命质量呈显著负相关(r=-0.864,P＜0.001).结构方程模型拟合良好[x2/自由度比(x2/df)=2.143、增值适配指数(IFI)=0.983、非规准适配指数(TLI=NNFI)=0.976、比较适配指数(CFI)=0.983、渐进残差均方和平方根(RMSEA)=0.066].中介效应分析表明,自我效能感在疾病反刍思维与心理健康相关生命质量之间起部分中介作用[间接效应(95％CI)=-0.471(-0.574～-0.382),P＜0.001;直接效应(95％CI)=-0.484(-0.608～-0.373),P＜0.001;总效应(95％CI)=-0.955(-1.069～-0.854),P＜0.001],间接效应(中介效应)占总效应的49.32％.结论:COPD患者的疾病反刍思维可通过降低自我效能感间接影响其心理健康相关生命质量.临床干预中应重视提升患者的自我效能感,以缓解反刍思维对心理健康相关生命质量的不良影响.
Objective:To explore the impact of patient's rumination of disease on their psychological health-related quality of life in patients with chronic obstructive pulmonary disease(COPD),and to examine the mediating role of self-efficacy between these two variables.Methods:A convenience sampling method was used to select 263 COPD patients admitted to Shanghai Second People's Hospital between June 2023 and October 2025 as study subjects,according to inclusion criteria.A general information questionnaire,the General Self-Efficacy Scale,the Rumination Scale,and the SF-12 Quality of Life Scale were used to conduct a questionnaire survey on all subjects,and the corresponding scores were calculated.Spearman correlation analysis was performed on self-efficacy,rumination on disease,and mental health-related quality of life using SPSS 21.0 software.A structural equation model was constructed using Amos 28.0 software to test the mediating effect of self-efficacy.Results:The average scores for self-efficacy,patient's rumination on disease,and mental health-related quality of life in COPD patients were(23.42±5.51),(54.65±6.84),and(62.71±8.78),respectively.Spearman correlation analysis showed that self-efficacy was significantly negatively correlated with patient's rumination on disease(r=-0.798,P＜0.001)and significantly positively correlated with mental health-related quality of life(r=0.859,P＜0.001);patient's rumination on disease was significantly negatively correlated with mental health-related quality of life(r=-0.864,P＜0.001).The structural equation model fitted well(x2/dF=2.143,IFI=0.983,TLI=0.976,CFI=0.983,RMSEA=0.066).Mediation analysis showed that self-efficacy partially mediated the relationship between patient's rumination on disease and quality of life related to mental health(indirect effect(95％CI)=-0.471(-0.574 to-0.382),P＜0.001;direct effect(95％CI)=-0.484(-0.608 to-0.373),P＜0.001;total effect(95％CI)=-0.955(—1.069 to-0.854),P＜0.001),with the mediating effect accounting for 49.32％of the total effect.Conclusion:Patient's rumination on COPD can indirectly affect their mental health-related quality of life by reducing self-efficacy.Clinical interventions should emphasize on improving patients' self-efficacy to mitigate the adverse effects of patient's rumination of COPD on their mental heal th-related quality of life.
沈伟;周玉婷;蒋玲
上海市第二人民医院急诊病房,上海 200011上海市第二人民医院急诊病房,上海 200011上海市第二人民医院急诊病房,上海 200011
医药卫生
自我护理肺疾病,慢性阻塞性自我心理学生命价值护理评价研究
Self carePulmonary disease,chronic obstructiveSelf psychologyValue of lifeNursing evaluation research
《结核与肺部疾病杂志》 2026 (3)
294-301,8
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