心理韧性在首发脑卒中病人焦虑抑郁与疾病不确定感间的中介作用

Mediating Effect of Resilience on the Relationship between Anxiety, Depression and Illness Uncertainty in First-Episode Stroke Patients

摘要: 目的：本研究旨在探讨首发脑卒中病人的心理弹性对其焦虑、抑郁、疾病不确定性的调节作用。方法：本研究以湖北省一家三级综合医院首次发病的204名病人为研究对象，从2024年1月到12月进行了随机抽样。通过一般资料调查表、心理韧性量表简版(CD-RISC-10)、医院焦虑抑郁量表(HADS)及中文版疾病不确定感量表(MUIS-A)开展调查，利用SPSS 23.0分析三者的相关性，并借助AMOS 23.0构建模型以验证心理韧性的中介作用。结果：该群体焦虑抑郁总分为(21.98 ± 8.23)分，心理韧性得分为(28.18 ± 6.46)分，疾病不确定感得分为(73.22 ± 11.43)分。相关性分析显示，疾病不确定感与心理韧性之间存在明显的负相关(r = −0.597, P < 0.01)，与焦虑抑郁之间呈现出显著正相关(r = 0.573, P < 0.01)，此外，心理韧性与焦虑抑郁之间存在着明显的负相关(r = −0.504, P < 0.01)。中介效应分析表明，心理韧性对患者的焦虑、抑郁和疾病不确定性有一定的调节作用，其调节效果为0.294，占总效应的39.1%。结论：首发脑卒中患者的疾病不确定感处于中等水平，焦虑抑郁情绪较明显，心理韧性水平偏低；心理韧性在焦虑抑郁与疾病不确定感间存在部分中介效应。提示医护人员可通过缓解患者焦虑抑郁情绪、提升其心理韧性，降低疾病不确定感。

Abstract: Objective: The purpose of this study was to investigate the moderating effect of psychological resilience on anxiety, depression, and disease uncertainty in first-episode stroke patients. Methods: A random sample of 204 patients with first-ever stroke in a tertiary general hospital in Hubei Province from January to December 2024 was used in this study. Investigations were carried out by means of a general information questionnaire, the short version of the Mental Toughness Scale (CD-RISC-10), the Hospital Anxiety and Depression Scale (HADS), and the Chinese version of the Measure of Uncertainty in Illness (MUIS-A), and the correlations among the three were analyzed by using SPSS 23.0, and a model was constructed with the help of AMOS 23.0 to verify the mediating role of mental toughness. Results: The group had a total score of (21.98 ± 8.23) for anxiety and depression, (28.18 ± 6.46) for mental toughness, and (73.22 ± 11.43) for illness uncertainty. Correlation analysis showed that there was a significant negative correlation between illness uncertainty and mental toughness (r = −0.597, P < 0.01), and a significant positive correlation with anxiety and depression (r = 0.573, P < 0.01), in addition to this significant negative correlation between mental toughness and anxiety and depression (r = −0.504, P < 0.01). The mediation effect analysis showed that mental toughness had a moderating effect on patients’ anxiety, depression and disease uncertainty, with a moderating effect of 0.294, accounting for 39.1% of the total effect. Conclusion: First-ever stroke patients have a moderate level of disease uncertainty, more pronounced anxiety and depression, and a low level of mental toughness; there is a partial mediating effect of mental toughness between anxiety and depression and disease uncertainty. This suggests that healthcare professionals can reduce the sense of uncertainty by alleviating patients’ anxiety and depression and improving their mental toughness.