脑损伤康复期患者及配偶的共同二元应对与婚姻满意度和生活质量的关系：基于共同命运模型的分析

doi:10.3969/j.issn.1006-9771.2023.12.009

《中国康复理论与实践》 ›› 2023, Vol. 29 ›› Issue (12): 1446-1453.doi: 10.3969/j.issn.1006-9771.2023.12.009

脑损伤康复期患者及配偶的共同二元应对与婚姻满意度和生活质量的关系：基于共同命运模型的分析

付文娟¹^,²^,³, 侯剑华⁴, 于肖楠⁴(), 陈天勇¹^,²()

1.中国科学院心理健康重点实验室(中国科学院心理研究所)，北京市 100101
2.中国科学院大学心理学系，北京市 100049
3.中国康复研究中心北京博爱医院贵宾中心，北京市 100068
4.香港城市大学社会及行为科学系，香港 999077

收稿日期:2023-08-11 修回日期:2023-11-16 出版日期:2023-12-25 发布日期:2023-12-28
通讯作者: 于肖楠，女，博士，副教授，博士研究生导师。E-mail： Nancy.yu@cityu.edu.hk；陈天勇，男，博士，副研究员，博士研究生导师。E-mail： chenty@psych.ac.cn
作者简介:付文娟(1981-)，女，汉族，河北衡水市人，硕士研究生，主管护师，主要研究方向：神经康复护理，护理心理。
基金资助:
国家重点研发计划项目(2020YFC2003000)

Relationship of common dyadic coping to marital satisfaction and quality of life for patients with brain injury and their spouses in a rehabilitation facility: using common fate model

FU Wenjuan¹^,²^,³, HOU Jianhua⁴, YU Xiaonan⁴(), CHEN Tianyong¹^,²()

1. CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China
2. Department of Psychology, University of Chinese Academy of Sciences, Beijing 100049, China
3. VIP Ward, Department of Neurorehabilitation, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing 100068, China
4. Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong 999077, China

Received:2023-08-11 Revised:2023-11-16 Published:2023-12-25 Online:2023-12-28
Contact: YU Xiaonan, E-mail: Nancy.yu@cityu.edu.hk; CHEN Tianyong, E-mail: chenty@psych.ac.cn
Supported by:
National Key Research and Development Program(2020YFC2003000)

摘要/Abstract

摘要：

目的基于共同命运模型，考察康复机构脑损伤后功能障碍患者与配偶的共同二元应对水平，探讨其与夫妻的婚姻满意度和生活质量的关系。

方法 2022年10月至2023年6月，选取北京博爱医院脑损伤住院患者101例，患者夫妻填写共同二元应对量表、Kansas婚姻满意度量表、世界卫生组织生活质量简表。

结果共同二元应对水平与婚姻满意度呈显著正相关(β = 0.814, P < 0.001)。共同二元应对水平与各自的生活质量呈显著正相关(β = 0.271, P = 0.038; β = 0.481, P < 0.001)；其中，配偶在身体健康、心理、社会关系和环境方面均与共同二元应对水平呈显著正相关，患者仅在心理和社会关系维度显著相关。

结论面对脑损伤应激，患者夫妻的共同二元应对水平可正向预测双方的婚姻满意度和生活质量，且对配偶的预测效应更强。宜将患者夫妻作为整体，纳入临床管理，促进双方心理积极适应，提高康复效果。

关键词: 脑损伤, 共同二元应对, 婚姻满意度, 生活质量, 共同命运模型, 康复

Abstract:

Objective To investigate common dyadic coping (CDC) in linking with marital satisfaction and quality of life (QOL) in patients with brain injury and their spouses in a rehabilitation facility by using common fate model (CFM).

Methods From October, 2022 to June, 2023, 101 brain injury inpatients and their spouses in Beijing Bo'ai Hospital completed the questionnaire of Dyadic Coping Inventory, Kansas Marital Satisfaction Scale and World Health Organization Quality of Life.

Results The level of CDC between patients and their spouses significantly positively correlated with their marital satisfaction for both partners (β= 0.814, P < 0.001), as well as correlated with their quality of life (β = 0.271, P = 0.038; β = 0.481, P < 0.001). For the dimensions of QOL, the physical, psychological, social relationship and environmental dimensions significantly positive correlated with the CDC for the spouses, and only psychological and social relationship dimensions for the patients.

Conclusion Facing the stress of brain injury, the level of CDC within couples can positively predict their marital satisfaction and QOL, and effect seems stronger for the spouses. It is advisable to consider both brain injured patients and their spouses as a whole to promote psychological adaptation and improve rehabilitation outcomes.

Key words: brain injury, common dyadic coping, marital satisfaction, quality of life, common fate model, rehabilitation

中图分类号:

R651.1

付文娟, 侯剑华, 于肖楠, 陈天勇. 脑损伤康复期患者及配偶的共同二元应对与婚姻满意度和生活质量的关系：基于共同命运模型的分析[J]. 《中国康复理论与实践》, 2023, 29(12): 1446-1453.

FU Wenjuan, HOU Jianhua, YU Xiaonan, CHEN Tianyong. Relationship of common dyadic coping to marital satisfaction and quality of life for patients with brain injury and their spouses in a rehabilitation facility: using common fate model[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(12): 1446-1453.

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项目	患者(n = 101)	配偶(n = 101)	t/χ²值	P值
年龄/岁	53.15±10.09	52.03±10.75	3.108	0.002
受教育年限/年	13.06±4.05	13.31±3.89	-0.747	0.457
女性占比/%	21.78	78.20	89.602	< 0.001
婚龄/年	26.72±11.29
家庭月收入/元	≥ 5 000占89.11%
配偶有无慢性疾病	有慢性疾病占29.70%
病程/d	117.97±119.07
并发症数量/n	5.37±3.61
简易精神状态检查评分	25.56±4.73
运动功能评级	2.00±1.12
日常生活能力评级	3.04±0.98
功能障碍/n
运动	91
言语/构音	55
吞咽	13
认知	42
情绪	22
排泄	2
感觉	46
平衡	51

项目	患者(n = 101)	配偶(n = 101)	t值	P值
他/她的疾病对你情绪的影响	7.19±2.97	6.32±2.96	2.326	0.022
导致(他/她的)疾病最主要原因/n			-0.261	0.794
高血压	39	39
不良生活方式	29	30
你和配偶对疾病评估的一致度	5.36±1.52	5.34±1.32	0.145	0.885
影响日常生活能力最主要原因/n			1.198	0.234
肢体功能障碍	73	80
认知障碍	20	14
其他	3	7

项目	患者(n = 101)	配偶(n = 101)	t值	P值
CDC	13.39±4.16	12.76±4.34	1.37	0.170
C-KMS	14.97±2.99	13.70±3.34	3.58	0.001
WHOQOL-BREF	59.77±15.38	64.70±14.14	-2.76	0.007
身体健康	1.90±0.64	2.59±0.57	-8.98	< 0.001
心理	2.39±0.73	2.48±0.65	-6.76	< 0.001
社会关系	2.68±0.69	2.67±0.58	0.04	0.967
环境	2.51±0.70	2.36±0.68	1.81	0.074

项目			CDC		婚姻满意度		WHOQOL-BREF		WHOQOL-BREF
			患者	配偶	患者	配偶	患者	配偶	患者				配偶
			患者	配偶	患者	配偶	患者	配偶	身体健康	心理	社会关系	环境	身体健康	心理	社会关系
CDC	配偶		0.425^a
婚姻满意度	患者		0.533^a	0.323^a
婚姻满意度	配偶		0.327^a	0.603^a	0.375^a
WHOQOL-BREF	患者		0.274^a	0.096	0.259^a	0.161
WHOQOL-BREF	配偶		0.231^b	0.483^a	0.143	0.489^a	0.262^a
WHOQOL-BREF	患者	身体健康	0.101	0.072	0.070	0.116	0.826^a	0.267^a
		心理	0.326^a	0.090	0.296^a	0.091	0.856^a	0.235^b	0.604^a
		社会关系	0.242^b	0.194^c	0.333^a	0.249^b	0.758^a	0.273^a	0.514^a	0.642^a
		环境	0.289^a	0.036	0.244^b	0.110	0.895^a	0.173^c	0.587^a	0.696^a	0.677^a
	配偶	身体健康	0.149	0.289^a	0.102	0.344^a	0.163	0.819^a	0.199^b	0.125	0.205^b	0.078
		心理	0.244^b	0.504^a	0.128	0.478^a	0.180^c	0.880^a	0.181^c	0.218^b	0.222^b	0.092	0.629^a
		社会关系	0.140	0.454^a	0.082	0.277^a	0.146	0.746^a	0.173^c	0.123	0.202^b	0.073	0.523^a	0.593^a
		环境	0.237^b	0.435^a	0.139	0.426^a	0.326^a	0.911^a	0.302^a	0.292^a	0.265^a	0.261^a	0.611^a	0.731^a	0.688^a

脑损伤康复期患者及配偶的共同二元应对与婚姻满意度和生活质量的关系：基于共同命运模型的分析

Relationship of common dyadic coping to marital satisfaction and quality of life for patients with brain injury and their spouses in a rehabilitation facility: using common fate model

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