中华现代护理杂志2024,Vol.30Issue(23) :3185-3190.DOI:10.3760/cma.j.cn115682-20240117-00323

疾病不确定感在老年慢性心力衰竭患者自我效能与个人掌控感间的中介效应分析

Mediating effect of uncertainty in illness between self-efficacy and sense of personal mastery in aged patients with chronic heart failure

林春敏 宋丹丹 程丽
中华现代护理杂志2024,Vol.30Issue(23) :3185-3190.DOI:10.3760/cma.j.cn115682-20240117-00323

疾病不确定感在老年慢性心力衰竭患者自我效能与个人掌控感间的中介效应分析

Mediating effect of uncertainty in illness between self-efficacy and sense of personal mastery in aged patients with chronic heart failure

林春敏 1宋丹丹 2程丽2
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作者信息

  • 1. 吉林大学中日联谊医院老年病科,长春 130033
  • 2. 吉林大学中日联谊医院消化内科,长春 130033
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摘要

目的 探讨自我效能对老年慢性心力衰竭患者个人掌控感的直接影响,以及疾病不确定感的间接影响,以期为制订改善老年慢性心力衰竭患者个人掌控感的干预措施提供理论依据.方法 采用便利抽样法,选取2023年1-11月在吉林大学中日联谊医院老年病科住院的240例老年慢性心力衰竭患者为研究对象.采用个人掌控量表、疾病不确定感量表、一般自我效能量表对患者进行调查.采用Bootstrap法检验疾病不确定感在老年慢性心力衰竭患者自我效能与个人掌控感间的中介效应.结果 本研究发放问卷240份,回收有效问卷221份,回收有效率为92.08%.221例老年慢性心力衰竭患者个人掌控量表总分为(21.49±5.92)分;疾病不确定感量表总分为(75.00±20.94)分;一般自我效能量表总分为(21.15±6.10)分.中介效应分析结果显示,自我效能对个人掌控感的总效应为0.557(95%CI:0.438~0.659,P=0.001);自我效能对个人掌控感的直接效应为0.311(95%CI:0.157~0.455,P=0.001);自我效能对个人掌控感的间接效应为0.246(95%CI:0.169~0.344,P<0.001).疾病不确定感在老年慢性心力衰竭患者自我效能与个人掌控感间起部分中介效应,中介效应占总效应的44.17%.结论 老年慢性心力衰竭患者个人掌控感处于较低水平.临床医务工作者应采取一定的干预措施提高患者的自我效能,降低患者的疾病不确定感,从而改善其个人掌控感.

Abstract

Objective To explore the direct impact of self-efficacy on the sense of personal mastery and the indirect impact mediated by uncertainty in illness in aged patients with chronic heart failure(CHF),and provide a theoretical basis for developing interventions to improve the sense of personal mastery in this patient population.Methods Totally 240 aged CHF patients hospitalized in the Department of Geriatrics at the China-Japan Union Hospital of Jilin University from January to November 2023 were selected by convenience sampling.They were surveyed using the Personal Mastery Scale(PMS),the Mishel Uncertainty in Illness Scale(MUIS),and the General Self-Efficacy Scale(GSES).The Bootstrap method was employed to test the mediating effect of uncertainty in illness between self-efficacy and the sense of personal mastery.Results A total of 240 questionnaires were distributed,with 221 valid responses collected,yielding a response rate of 92.08%.The total score for the PMS was(21.49±5.92),the total score for the MUIS was(75.00±20.94),and the total score for the GSES was(21.15±6.10).Mediating effect analysis showed that the total effect of self-efficacy on the sense of personal mastery was 0.557(95%CI:0.438-0.659;P=0.001);the direct effect was 0.311(95%CI:0.157-0.455;P=0.001);and the indirect effect through uncertainty in illness was 0.246(95%CI:0.169-0.344;P<0.001).Uncertainty in illness partially mediated the relationship between self-efficacy and the sense of personal mastery,accounting for 44.17%of the total effect.Conclusions The sense of personal mastery in aged CHF patients is relatively low.Clinical healthcare providers should implement interventions to enhance patients'self-effiicacy and reduce uncertainty in illness,thereby improving their sense of personal mastery.

关键词

老年人/慢性心力衰竭/个人掌控感/自我效能/疾病不确定感

Key words

Aged/Chronic heart failure/Sense of personal mastery/Self-efficacy/Uncertainty in illness

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出版年

2024
中华现代护理杂志
中华医学会

中华现代护理杂志

CSTPCD
影响因子:1.14
ISSN:1674-2907
参考文献量23
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