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护理学报 ›› 2019, Vol. 26 ›› Issue (11): 15-19.doi: 10.16460/j.issn1008-9969.2019.11.015

• 研究生园地 • 上一篇    下一篇

健康素养在心功能衰竭患者抑郁与自护维持的中介作用

何登鑫, 范秀珍   

  1. 山东大学 护理学院,山东 济南 250012
  • 收稿日期:2019-02-18 发布日期:2020-07-08
  • 通讯作者: 范秀珍(1965-),女,山东济南人,博士研究生,教授,博士研究生导师。
  • 作者简介:何登鑫(1993-),男,湖北利川人,本科学历,硕士研究生在读。

Mediation Effect of Health Literacy between Depression and Self-care Maintenance in Patients with Heart Failure

HE Deng-xin, FAN Xiu-zhen   

  1. Nursing school, Shandong University, Jinan 250012, China
  • Received:2019-02-18 Published:2020-07-08

摘要: 目的 了解心功能衰竭患者自护维持的现状,分析健康素养在心功能衰竭患者抑郁症状与自护维持间的中介作用,为提高心功能衰竭患者自护维持提供依据。方法 方便抽取山东省某三级甲等医院321例住院的心功能衰竭患者,使用问卷调查患者的自护维持、抑郁症状、健康素养、一般资料及临床特征。结果 心功能衰竭患者健康素养得分为48.4分;Pearson相关分析显示:抑郁症状与自护维持(r=-0.265,P<0.001)、健康素养(r=-0.462,P<0.001)均呈负相关,健康素养与自护维持呈正相关(r=0.407,P<0.001)。在中介检验中,控制协变量同时将抑郁和健康素养纳入回归中,抑郁症状与自护维持的相关系数下降36.3%(β=-0.137,P=0.017)。结论 健康素养在心功能衰竭患者抑郁症状与自护维持间起部分中介作用。医护人员在制定干预措施提高存在抑郁症状的心功能衰竭患者的自护维持时,除减轻心功能衰竭患者的抑郁症状外,改善心功能衰竭患者的健康素养也是一个新的干预思路。

关键词: 心功能衰竭, 自护维持, 抑郁症状, 健康素养, 中介作用

Abstract: Objectives To assess patients' self-care maintenance and explore the mediation effect of health literacy between depression and self-care maintenance in patients with heart failure (HF). Methods We recruited 321 patients with HF in a hospital in Shandong province and they were surveyed by using self-designed questionnaires to assess patients' depressive symptoms, health literacy and self-care maintenance. Results The score of health literacy of HF patients was 48.4. Pearson's correlation analysis showed depressive symptoms were negatively associated with self-care maintenance (r=-0.265, P<0.001) and health literacy (r=-0.462, P<0.001) but health literacy was positively associated with self-care maintenance(r=0.407, P<0.001). Mediation effect analysis showed that when both depression and health literacy entered the regression equation, coefficient of correlation between depressive symptoms and self-care maintenance decreased to 36.3% (β=-0.137,P=0.017). Conclusion Health literacy plays a partly mediating role between depressive symptoms and self-care maintenance. In addition to the improvement of depressive symptoms, health literacy should be taken into consideration when formulating interventions for improving self-care maintenance of patients with HF.

Key words: heart failure, self-care maintenance, depressive symptoms, health literacy, mediating effect

中图分类号: 

  • R473.54
[1] Ditewig J B, Blok H, Havers J, et al.Effectiveness of Self-management Interventions on Mortality, Hospital Readmissions, Chronic Heart Failure Hospitalization Rate and Quality of Life in Patients with Chronic Heart Failure: A Systematic Review[J]. Patient Educ Counsel, 2010, 78(3SI):297-315.
[2] Buck H G, Dickson V V, Fida R, et al.Predictors of Hospitalization and Quality of Life in Heart Failure: A Model of Comorbidity, Self-efficacy and Self-care[J]. Int J Nurs Studies, 2015, 52(11):1714-1722.
[3] Hamar G B, Rula E Y, Coberley C, et al.Long-Term Impact of a Chronic Disease Management Program on Hospital Utilization and Cost in An Australian Population with Heart Disease or Diabetes[J].Bmc Health Services Research, 2015, 15(174).
[4] Jaarsma T, Stromberg A, Ben Gal T, et al.Comparison of Self-care Behaviors of Heart Failure Patients in 15 Countries Worldwide[J].Patient Educ Counsel, 2013, 92(1):114-120.
[5] Celano C M, Villegas A C, Albanese A M, et al.Depression and Anxiety in Heart Failure: A Review[J]. Harvard Review of Psychiatry, 2018, 26(4):175-184.
[6] N'Goran A A, Pasquier J, Deruaz-Luyet A, et al. Factors Associated with Health Literacy in Multimorbid Patients in Primary Care: A Cross-sectional Study in Switzerland[J]. BMJ Open, 2018, 8(2):e18281.
[7] Wu J, Reilly C M, Holland J, et al.Relationship of Health Literacy of Heart Failure Patients and Their Family Members on Heart Failure Knowledge and Self-care[J]. J Family Nurs, 2017, 23(1):116-137.
[8] 陈巍,林平,李玲. 中文版心力衰竭患者自我护理行为量表的信效度检测[J]. 中华护理杂志, 2013, 48(7):629-631.
[9] 孙浩林,彭慧,傅华. 慢性病病人健康素养量表的维度结构分析[J]. 环境与职业医学, 2012, 29(11):706.
[10] 孙振晓,刘化学,焦林瑛,等. 医院焦虑抑郁量表的信度及效度研究[J]. 中华临床医师杂志(电子版), 2017, 11(2): 198-201.
[11] Shimizu Y, Suzuki M, Okumura H, et al.Risk Factors For Onset of Depression after Heart Failure Hospitalization[J]. J Cardiol, 2014, 64(1):37-42.
[12] Bjelland I, Dahl A A, Haug T T, et al.The Validity of the Hospital Anxiety and Depression Scale - An Updated Literature Review[J].J Psychosomatic Res, 2002, 52:69-77.
[13] Baron R M, Kenny D A.The Moderator-Mediator Variable Distinction In Social Psychological Research: Conceptual, Strategic, And Statistical Considerations[J]. J Pers Soc Psychol, 1986, 51(6):1173-1182.
[14] 陈巍,李玲,王蕊,等. 心力衰竭病人自护行为调查分析[J]. 护理研究, 2016, 30(11):1329-1332.
[15] Celano C M, Villegas A C, Albanese A M,et al.Depression and Anxiety in Heart Failure: A Review[J]. Harvard Review of Psychiatry, 2018, 26(4):175-184.
[16] Yang I, Kang Y.Self-care Model Based on the Theory of Unpleasant Symptoms in Patients with Heart Failure[J]. Applied Nursing Research: ANR, 2018, 43:10-17.
[17] Tsuchihashi-Makaya M, Matsuoka S, Ishida H, et al.Perceived Control Mediates Association Between Health Literacy and Self-care Behavior in Heart Failure Patients[J]. Circulation, 2017, 136(S1):A16236.
[18] Matsuoka S, Tsuchihashi-Makaya M,Kayane T,et al.Health Literacy is Independently Associated with Self-care Behavior in Patients with Heart Failure[J]. Patient Educ Counsel, 2016, 99(6):1026-1032.
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