心理资本在轻度认知障碍患者家庭功能与社会参与的中介效应

doi:10.16460/j.issn1008-9969.2023.02.060

摘要/Abstract

摘要： 目的探究心理资本在轻度认知障碍患者家庭功能与社会参与间的中介效应。方法采用便利抽样法,采用一般资料问卷、家庭功能评定量表、积极心理资本问卷、轻度认知障碍患者社会参与问卷,对2021年5—12月在南京医科大学附属脑科医院记忆门诊就诊的199例轻度认知障碍患者进行问卷调查,构建并检验中介模型。结果本组轻度认知障碍患者的家庭功能所有条目均分为（2.39±0.36）分,心理资本所有条目均分为（4.40±1.08）分,社会参与所有条目均分为（2.45±0.59）分。轻度认知障碍患者的社会参与与家庭功能所有条目均分呈负相关（r=-0.624,P<0.01）,与心理资本呈正相关（r=0.587,P<0.01）,家庭功能与心理资本所有条目均分呈负相关（r=-0.672,P<0.01）。心理资本在轻度认知障碍患者家庭功能与社会参与之间发挥部分中介效应,效应占比32.76%。结论本组轻度认知障碍患者的家庭功能、社会参与处于中等偏低水平,心理资本处于中等水平,心理资本在轻度认知障碍患者家庭功能和社会参与间起部分中介作用。建议医务工作者关注患者的家庭状况与家庭功能、提升心理资本水平,以促进患者社会参与。

关键词: 轻度认知障碍, 家庭功能, 心理资本, 社会参与, 中介效应

Abstract: Objective To explore the mediating role of psychological capital between family functioning and social participation of patients with mild cognitive impairment (MCI). Methods With convenience sampling, 199 MCI patients who visited the memory clinic of Brain Hospital Affiliated to Nanjing Medical University from May to December 2021 were selected and surveyed by using general information questionnaire, Family Functioning Rating Scale, Positive Psychological Capital Questionnaire and Social Participation Questionnaire for patients with mild cognitive impairment. The mediation model was constructed and verified. Results The average score of family functioning, psychological capital and social participation was 2.39±0.36, 4.40±1.08 and 2.45±0.59 respectively. Social participation in patients with MCI was negatively correlated with all the items of family functioning (r=-0.624, P<0.01) and positively with psychological capital (r=0.587, P<0.01). Family functioning was negatively correlated with all the items of psychological capital (r=-0.672, P<0.01). Psychological capital played a partial mediating role between family function and social participation in patients with MCI, accounting for 32.76% of the total effect. Conclusion In this study, family functioning and social participation of patients with MCI are at a moderately low level, and psychological capital is at a medium level. Psychological capital plays a partial mediating role between family functioning and social participation. It is suggested that medical workers pay attention to the family status and family functioning of patients with MCI and improve their psychological capital, so as to promote social participation of the patients.

Key words: mild cognitive impairment, family functioning, psychological capital, social participation, mediating role

中图分类号:

R473.74

焦雨晨, 嵇艳, 孟瑶, 许丽娟. 心理资本在轻度认知障碍患者家庭功能与社会参与的中介效应[J]. 护理学报, 2023, 30(2): 60-66.

JIAO Yu-chen, JI Yan, MENG Yao, XU Li-juan. Mediating role of psychological capital between family functioning and social participation in patients with mild cognitive impairment[J]. Journal of Nursing, 2023, 30(2): 60-66.

参考文献

[1] Jia L, Du Y, Chu L, et al.Prevalence, risk factors, and management of dementia and mild cognitive impairment in adults aged 60 years or older in China: a cross-sectional study[J]. Lancet Public Health, 2020, 5(12):e661-e671. DOI:10.1016/S2468-2667(20)30185-7.
[2] Neal D, van den Berg F, Planting C, et al. Can use of digital technologies by people with dementia improve self-management and social participation? a systematic review of effect studies[J]. J Clin Med, 2021, 10(4):604. DOI:10.3390/jcm10040604.
[3] Arvanitakis Z, Shah RC, Bennett DA.Diagnosis and management of dementia: review[J]. JAMA, 2019, 322(16):1589-1599. DOI: 10.1001/jama.2019.4782.
[4] Chanda S, Mishra R.Impact of transition in work status and social participation on cognitive performance among elderly in india[J]. BMC Geriatr, 2019, 19(1):251. DOI: 10.1186/s12877-019-1261-5.
[5] Amano T, Morrow-Howell N, Park S.Patterns of social engagement among older adults with mild cognitive impairment[J]. J Gerontol B Psychol Sci Soc Sci, 2020, 75(7):1361-1371. DOI: 10.1093/geronb/gbz051.
[6] White JM, Klein DM.Family theories[M]. 3rd ed. London: SAGE Publications, 2007.
[7] 敬少丽. 家庭功能的变迁与教育机会的发展——以社会性别理论为视角[J]. 教育理论与实践,2012,32(6):14-17.
[8] 钟清玲,喻思思.社区老年人社会参与水平及其影响因素的研究进展[J].中国护理管理,2018,18(9):1293-1296. DOI: 10.3969/j.issn.1672-1756.2018.09.031.
[9] 卓然. 流动儿童的社会融合问题及对策——基于家庭系统理论的视角[J]. 长春师范大学学报(自然科学版),2016,35(6):67-70. DOI:10.3969/j.issn.1008-178X(z).2016.06.022.
[10] Luthans F, Avolio BJ, Avey JB, et al.Positive psychological capital:measurement and relationship with performance and satisfaction[J]. Pers Psychol, 2010, 60(3):541-572. DOI: 10.1111/j.1744-6570.2007.00083.x
[11] Zakiei A, Vafapoor H, Alikhani M, et al.The relationship between family function and personality traits with general self-efficacy (parallel samples studies)[J]. BMC Psychol, 2020, 8(1):88. DOI:10.1186/s40359-020-00462-w.
[12] Takahashi K, Sase E, Kato A, et al.Psychological resilience and active social participation among older adults with incontinence: a qualitative study[J]. Aging Ment Health,2016,20(11):1167-1173.DOI:10.1080/13607863.2015.1065792.
[13] 涂成皓. 心理因素对中风患者生命质量的影响[D].沈阳:中国医科大学,2019.
[14] 于金美,陈爱妹,卢万俊,等. 轻度认知障碍病人的抑郁情绪与家庭亲密度和适应性的研究[J]. 护理研究,2016,30(34):4350-4352.DOI:10.3969/j.issn.1009-6493.2016.34.041.
[15] Roberto KA, Blieszner R, McCann BR, et al. Family triad perceptions of mild cognitive impairment[J]. J Gerontol B Psychol Sci Soc Sci,2011,66(6):756-768.DOI:10.1093/geronb/gbr107.
[16] 中国痴呆与认知障碍诊治指南写作组,杜怡峰,吕佩源,等.2018中国痴呆与认知障碍诊治指南(五):轻度认知障碍的诊断与治疗[J].中华医学杂志,2018,98(17):1294-1301. DOI: 10.3760/cma.j.issn.0376-2491.2018.17.003.
[17] 李铮,刘宇.护理学研究方法[M]. 2版.北京:人民卫生出版社, 2018: 58.
[18] Epstein NB, Baldwin LM, Bishop DS.The McMaster family assessment device[J]. J Marriage Fam Ther,1983,9(2):171-180.DOI:10.1111/j.1752-0606.1983.tb01497.x.
[19] 李荣风,徐夫真,纪林芹,等.家庭功能评定量表的初步修订[J].中国健康心理学杂志,2013, 21(7):996-1000. DOI:10.13342/j.cnki.cjhp.2013.07.003.
[20] 张阔,张赛,董颖红.积极心理资本:测量及其与心理健康的关系[J].心理与行为研究,2010,8(1):58-64. DOI:10.3969/j.issn.1672-0628.2010.01.011.
[21] 吴晓蕾,李琳,许乐.烧伤患者出院后社会参与水平现状及其影响因素研究[J].中国护理管理, 2017,17(12):1663-1668. DOI: 10.3969/j.issn.1672-1756.2017.12.019.
[22] 李甘,郭雁飞,黄哲宙,等.中国50岁及以上人群社会参与度和抑郁的关联研究[J].中华疾病控制杂志,2020,24(4):399-403.DOI: 10.16462/j.cnki.zhjbkz.2020.04.006.
[23] Levasseur M, Richard L, Gauvin L, et al.Inventory and analysis of definitions of social participation found in the aging literature: proposed taxonomy of social activities[J].Soc Sci Med,2010,71(12):2141-2149.DOI: 10.1016/j.socscimed.2010.09.041.
[24] Mlinac ME, Feng MC.Assessment of activities of daily living, self-Care, and independence[J].Arch Clin Neuropsychol,2016,31(6):506-516.DOI:10.1093/arclin/acw049.
[25] Hackett K, Mis R, Drabick DAG, et al.Informant reporting in mild cognitive impairment: sources of discrepancy on the functional activities questionnaire[J]. J Int Neuropsychol Soc,2020,26(5):503-514.DOI:10.1017/S1355617719001449.
[26] 姚尚莹,王林珠,朱雅丽. 丧偶对老年人社会活动参与的影响研究—基于中国健康与养老追踪调查(CHARLS) 数据的分析[J]. 生产力研究,2020(11):1-4. DOI:10.3969/j.issn.1004-2768.2020.11.001.
[27] 张文娟,赵德宇. 城市中低龄老年人的社会参与模式研究[J].人口与发展,2015,21(1):78-88. DOI: 10.3969/j.issn.1674-1668.2015.01.009.
[28] 史静琤,莫显昆,孙振球.量表编制中内容效度指数的应用[J].中南大学学报(医学版),2012,37(2):152-155. DOI:10.3969/j.issn.1672-7347.2012.02.007.
[29] 吴明隆. 结构方程模型:AMOS 的操作与应用[M]. 2版.重庆: 重庆大学出版社, 2010:212-260.
[30] 温忠麟,叶宝娟.中介效应分析:方法和模型发展[J].心理科学进展, 2014, 22(5):731-745.DOI:10.3724/SP.J.1042.2014.00731.
[31] Dai B, Mao Z, Mei J, et al.Caregivers in China: knowledge of mild cognitive impairment[J]. PLoS One, 2013, 8(1):e53928. DOI: 10.1371/journal.pone.0053928.
[32] 杨姣,陈芳,程利. 护士心理资本、工作-家庭支持对离职意愿的影响:隐性缺勤的中介作用[J].中国卫生统计,2021,38(1):54-58.DOI:10.3969/j.issn.1002-3674.2021.01.014.
[33] 杨秀坤. 轻度认知障碍患者的家庭功能及相关因素的调查研究[J].卫生职业教育,2012,30(12):125-127. DOI: 10.3969/j.issn.1671-1246.2012.12.076.
[34] 赵钰雪,朱慧,宗屹,等. 基于Logistic回归和决策树的癌症患者及照顾者家庭功能影响因素分析[J].齐鲁护理杂志,2022, 28(11):23-30. DOI:10.3969/j.issn.1006-7256.2022.11.007.
[35] 吴宗壁,韩晓苇,蓝丽娟,等. 中青年血液透析患者家庭功能现状及影响因素分析[J]. 中国护理管理,2019,19(12):1816-1821. DOI:10.3969/j.issn.1672-1756.2019.12.012.
[36] 张清,倪志红,赵雪萍,等. 慢性病患儿家庭功能状况及影响因素的研究进展[J]. 中国护理管理,2021,21(8):1276-1280. DOI:10.3969/j.issn.1672-1756.2021.08.031.
[37] 库敏,周巧学,周建荣,等.孤独感对社区老年人轻度认知障碍的影响[J].现代预防医学,2020,47(7):1223-1226.
[38] Burgener SC, Buckwalter K, Perkhounkova Y, et al.Perceived stigma in persons with early-stage dementia: longitudinal findings: part 1[J]. Dementia (London), 2015, 14(5):589-608. DOI:10.1177/1471301213508399.
[39] 李春梅. 心理资本对公众参与认知、态度和行为的影响研究[J]. 学术论坛,2018,41(2):155-162. DOI:10.3969/j.issn.1004-4434.2018.02.022.
[40] 王佳佳,方艳春,王蓉,等.心理资本在乳腺癌患者知觉压力与癌症复发恐惧间的中介效应[J].护理学杂志,2021,36(1):76-79.DOI:10.3870/j.issn.1001-4152.2021.01.076.
[41] Lima S, Sevilha S, Pereira MG.Quality of life in early-stage alzheimer’s disease: the moderator role of family variables and coping strategies from the patients’ perspective[J].Psychogeriatrics,2020, 20(5):557-567.DOI:10.1111/psyg.12544.
[42] Yuan Y, Xu HW, Zhang S, et al.The mediating effect of self-efficacy on the relationship between family functioning and quality of life among elders with chronic diseases[J]. Nurs Open,2021, 8(6):3566-3574. DOI:10.1002/nop2.906.
[43] 王雁飞,王丽璇,朱瑜. 基于资源保存理论视角的心理资本与员工创新行为关系研究[J]. 商业经济与管理,2019(3):40-49.DOI:10.14134/j.cnki.cn33-1336/f.2019.03.004.
[44] Ahlberg M, Hollman Frisman G, Berterö C, et al.Family health conversations create awareness of family functioning[J]. Nurs Crit Care (Ambler), 2020, 25(2):102-108. DOI: 10.1111/nicc.12454.
[45] Paun O.Pandemic lessons: resilience and hope[J]. J Psychosoc Nurs Men,2022,60(1):11-12.DOI:10.3928/02793695-20211207-03.
[46] 闫德修,章雅青. 心理资本干预应用现状及对护理的启示[J]. 中华现代护理杂志,2021,27(23):3081-3087. DOI:10.3760/cma.j.cn115682-20201219-06775.

Metrics

Viewed

Full text

Abstract

Cited

Shared