知觉压力影响创伤康复期患者事件影响程度的中介效应路径分析

doi:10.3969/j.issn.1006-9771.2023.08.013

《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (8): 954-960.doi: 10.3969/j.issn.1006-9771.2023.08.013

知觉压力影响创伤康复期患者事件影响程度的中介效应路径分析

刘洋¹, 张鹏¹, 黄英², 陈翰², 许辰¹, 李敏¹()

1.陆军军医大学医学心理系军事心理学教研室，重庆市 400038
2.陆军军医大学第一附属医院康复医学科，重庆市 400038

收稿日期:2023-04-25 修回日期:2023-06-29 出版日期:2023-08-25 发布日期:2023-10-09
通讯作者: 李敏 E-mail:limin52267@tmmu.com
作者简介:刘洋(1993-)，男，汉族，重庆市人，硕士研究生，主要研究方向：创伤康复期患者心理健康干预与促进。
基金资助:
陆军军医大学大学生培育项目(2022XBK22)

Path analysis of mediating effect of perceived stress affecting impact of event in rehabilitation patients with traumatic injury

LIU Yang¹, ZHANG Peng¹, HUANG Ying², CHEN Han², XU Chen¹, LI Min¹()

1. Department of Medical Psychology, Army Medical University, Chongqing 400038, China
2. Department of Rehabilitation Medicine, First Affiliated Hospital of Army Medical University, Chongqing 400038, China

Received:2023-04-25 Revised:2023-06-29 Published:2023-08-25 Online:2023-10-09
Contact: LI Min E-mail:limin52267@tmmu.com
Supported by:
Army Medical University College Student Cultivation Project(2022XBK22)

摘要/Abstract

摘要：

目的探讨知觉压力对创伤康复期患者事件影响程度的影响，以及情绪调节困难、沉思和睡眠的中介作用。
方法 2022年3月至2023年3月，方便抽取西南医院、新桥医院和大坪医院创伤康复期患者192例进行问卷调查。评估工具包括知觉压力量表、中文版情绪调节困难问卷、简版沉思反应量表、睡眠状况自评量表和事件影响量表修订版。
结果创伤康复期患者的知觉压力、情绪调节困难、沉思、睡眠和事件影响程度两两呈正相关(r = 0.447~0.684, P < 0.01)。知觉压力显著正向预测事件影响程度(β = 0.49, P < 0.001)，以及情绪调节困难(β=0.70, P < 0.001)、沉思(β = 0.21, P < 0.05)和睡眠(β = 0.29, P < 0.001)。知觉压力对事件影响程度的直接效应不显著，但可通过7条间接效应路径影响事件影响程度，其中情绪调节困难、沉思和睡眠的单一中介效应占比分别为24.41%、11.91%和24.82%，情绪调节困难和沉思的链式中介效应占比13.88%，情绪调节困难和睡眠的链式中介效应占比18.08%，沉思和睡眠的链式中介效应占比3.17%，情绪调节困难、沉思和睡眠的链式中介效应占比3.70%。
结论知觉压力通过情绪调节困难、沉思和睡眠的单一中介作用和链式中介作用影响创伤康复期患者的事件影响程度。

关键词: 知觉压力, 情绪调节困难, 沉思, 睡眠, 事件影响程度, 创伤, 康复

Abstract:

Objective To explore the effect of perceived stress on the impact of event in rehabilitation patients with traumatic injury, and the mediating role of difficulties in emotion regulation, rumination and sleep.
Methods From March, 2022 to March, 2023, using the convenient sampling method, a questionnaire survey was conducted on 192 rehabilitation patients with traumatic injury from Southwest Hospital, Xinqiao Hospital and Daping Hospital. Assessment tools included Perceived Stress Scale, Difficulties in Emotion Regulation Scale, Brief Ruminative Response Scale, Self-Rating Scale of Sleep, and Impact of Event Scale-revised.
Results Perceived stress, difficulties in emotion regulation, rumination, sleep and the impact of event were correlated with each other in rehabilitation patients with traumatic injury (r = 0.447~0.684, P < 0.01). Perceived stress significant positively predicted the impact of event (β = 0.49, P < 0.001), as well as difficulties in emotion (β = 0.70, P < 0.001), rumination (β = 0.21, P < 0.05) and sleep (β = 0.29, P < 0.001). The direct effect of perceived stress on the impact of event was not significant, but it affected the impact of event through seven mediation paths, among which the independent mediation effect size of difficulties in emotion regulation, rumination and sleep accounted for 24.41%, 11.91% and 24.82%, respectively; the chain mediation effect size of difficulties in emotion regulation and rumination accounted for 13.88%, the chain mediation effect size of difficulties in emotion regulation and sleep accounted for 18.08%, the chain mediation effect size of rumination and sleep accounted for 3.17%, and the chain mediation effect size of difficulties in emotion regulation, meditation and sleep accounted for 3.70%.
Conclusion Perceived stress affected the impact of event in rehabilitation patients with traumatic injury through the independent mediation and chain mediation of difficulties in emotion regulation, rumination and sleep.

Key words: perceived stress, difficulties in emotion regulation, rumination, sleep, impact of event, traumatic injury, rehabilitation

中图分类号:

R641

刘洋, 张鹏, 黄英, 陈翰, 许辰, 李敏. 知觉压力影响创伤康复期患者事件影响程度的中介效应路径分析[J]. 《中国康复理论与实践》, 2023, 29(8): 954-960.

LIU Yang, ZHANG Peng, HUANG Ying, CHEN Han, XU Chen, LI Min. Path analysis of mediating effect of perceived stress affecting impact of event in rehabilitation patients with traumatic injury[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(8): 954-960.

图/表 5

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变量	评分
知觉压力	23.91±9.35
情绪调节困难	80.92±21.79
沉思	20.16±6.41
睡眠	22.43±7.42
事件影响程度	28.51±18.89

变量	知觉压力	情绪调节困难	沉思	睡眠	事件影响程度
知觉压力	1
情绪调节困难	0.656^a	1
沉思	0.447^a	0.487^a	1
睡眠	0.539^a	0.585^a	0.447^a	1
事件影响程度	0.467^a	0.582^a	0.581^a	0.684^a	1

变量		整体拟合指数			回归系数显著性
结果变量	预测变量	R	R²	F	β	t值
事件影响程度		0.51	0.26	21.47^c
	性别				0.11	0.78
	年龄				0.29	2.68
	知觉压力				0.49	7.39^c
情绪调节困难		0.68	0.46	53.46^c
	性别				-0.08	-0.65
	年龄				0.30	3.27
	知觉压力				0.70	12.38^c
沉思		0.52	0.27	16.99^c
	性别				0.05	0.32
	年龄				-0.05	-0.48
	知觉压力				0.21	2.35^a
	情绪调节困难				0.35	4.09^c
睡眠		0.65	0.42	27.19^c
	性别				-0.08	-0.60
	年龄				0.22	2.24
	知觉压力				0.29	3.64^c
	情绪调节困难				0.30	3.85^c
	沉思				0.18	2.75^b
事件影响程度		0.77	0.59	44.41^c
	性别				0.17	1.53
	年龄				0.07	0.88
	知觉压力				-0.04	-0.55
	情绪调节困难				0.18	2.66^b
	沉思				0.30	5.37^c
	睡眠				0.45	7.26^c

项目	效应值	Boot标准误	95%CI		效应占比/%
项目	效应值	Boot标准误	下限	上限	效应占比/%
直接效应	-0.0385	0.0699	-0.1763	0.0993
总间接效应	0.5265	0.0694	0.3903	0.6633	100.00
间接效应1	0.1285	0.0503	0.0317	0.2287	24.41
间接效应2	0.0627	0.0317	0.0036	0.1287	11.91
间接效应3	0.1307	0.0428	0.0521	0.2205	24.82
间接效应4	0.0731	0.0249	0.0313	0.1287	13.88
间接效应5	0.0952	0.0311	0.0378	0.1612	18.08
间接效应6	0.0167	0.0112	0.0003	0.0426	3.17
间接效应7	0.0195	0.0092	0.0042	0.0400	3.70

知觉压力影响创伤康复期患者事件影响程度的中介效应路径分析

Path analysis of mediating effect of perceived stress affecting impact of event in rehabilitation patients with traumatic injury

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