摘要
目的分析维持性血液透析患者希望水平影响因素的直接与间接作用。方法采用自行设计的患者一般情况调查表、中文版Herth希望量表、透析患者症状困扰量表、简易应对方式问卷、社会支持量表对广州市三所三甲医院血液透析中心的182名维持性血液透析患者进行调查。采用结构方程建模的方法建立希望水平影响因素的回归模型。结果回归模型数据拟合度良好。χ2=13.0,df=12,P=0.371,RMSEA=0.021,GFI、AGFI、CFI、NFI、IFI均大于0.90。结构方程模型分析结果显示:症状困扰对希望水平有直接负向效应(β=-0.735,P<0.01),积极应对方式对希望水平有直接正向效应(β=0.171,P<0.01),消极应对方式对希望水平有直接负向效应(β=0.105,P<0.01)。积极应对方式、消极应对方式还可通过社会支持、症状困扰间接影响希望水平。结论结构方程模型对于量化分析多个潜变量复杂关系上独具优势。维持性血液透析患者积极、消极应对方式及症状困扰对希望水平有直接和间接影响。社会支持为中介变量调节应对方式、症状困扰与希望的关系。
Objective To analyze the direct and indirect outcomes of influencing factors on hope level for patients with maintenance hemodialysis.Method A total of 182 patients with maintenance hemodialysis were recruited from 3 dialysis centers in Guangzhou and were investigated with the self-designed questionnaire,Dialysis Symptom Index,the Herth Hope Scale,Simplified Coping Scale and Social Support Scale.Structural equation model was used to establish the regression model of the influencing factors on hope level.Result Established regression model fit well,χ2=13.0,df=12,P=0.371,RMSEA=0.021,and the figures of GFI,AGFI,CFI,NFI,IFI were all over 0.90.Structural equation modeling analysis showed that the symptom distress had direct negative effect on hope level（β=-0.735,P〈0.01）,and the positive coping style had the direct positive effect on hope level（β=-0.171,P〈0.01）,and the negative coping style had the direct negative effect on hope level（β=-0.105,P〈0.01）.And the positive coping style and the negative coping style could affect hope level through the social support and the symptom distress.Conclusion Structural equation models have unique advantages in analyzing the complex relationship of multiple latent variable.The positive coping style,the negative coping style and the symptom distress have direct or indirect effects on hope level in maintenance hemodialysis patients,and the social support as a mediated variable adjusts the relationship among coping style,symptom and hope level.
出处
《护士进修杂志》
2012年第8期677-679,共3页
Journal of Nurses Training
关键词
血液透析
希望
影响因素
结构方程模型
Hemodialysis Hope Influential factors Structural equation model
