ISSN 2096-7446　CN 10-1655/R
主管：中国科协技术协会
主办：中华护理学会
中华急危重症护理杂志

中华急危重症护理杂志 ›› 2024, Vol. 5 ›› Issue (1): 10-15.doi: 10.3761/j.issn.2096-7446.2024.01.001

• 论著 • 上一篇    下一篇

ICU身体约束患者心理弹性水平及影响因素的路径分析

陈巧玲 林如玉 朱宣静 别园园 赵慧玲   

  • 出版日期:2024-01-10 发布日期:2024-01-24

The levels of psychological resilience and influencing factors path analysis in ICU patients with physical restrain

CHEN Qiaoling，LIN Ruyu，ZHU Xuanjing，BIE Yuanyuan，ZHAO Huiling   

  • Online:2024-01-10 Published:2024-01-24

摘要： 目的 描述ICU身体约束患者心理弹性水平，并探讨其影响因素。 方法 采用一 般资料调查表、心理弹性量表、社会支持评定量表、一般自我效能感量表、医学应对方式问卷、艾森克人格问卷中文简版，选取2021年12月-2022年12月入住福建省某三级甲等医院重症医学科的301例身体约束患者进行调查， 采用结构方程模型分析各因素的影响路径。 结果 ICU身体约束患者心理弹性总分为（53.17±17.41）分，自我效能得分为（25.16±7.96）分，社会支持得分为（38.93±15.12）分，医学应对方式总分为（44.15±15.21）分，艾森克人格总分为（23.68±2.98）分。 ICU身体约束患者心理弹性总分与社会支持总分呈正相关（r=0.585，P<0.001），与自我效能总分呈正相关（r=0.545，P<0.01），与医学应对方式面对维度呈正相关（r=0.602，P<0.01），与屈服、回避 维度呈负相关（r=-0.567，P<0.01；r=-0.627，P<0.01），与人格特征内外向维度呈正相关（r=0.326， P<0,01），与神经质、精神质和掩饰性得分呈负相关（r=-0.395，P<0.01；r=-0.338，P<0.01；r=-0.362，P<0.01）。 构建的模型拟合度良好，其中社会支持对心理弹性存在正向直接效应和间接效应（β=0.546，P<0.001； β=0.267，P<0.001），自我效能对心理弹性存在正向直接效应 （ β=0.218，P=0.005）， 医学应对中面对的应对方式对心理弹性存在直接正向效应 （ β= 0.415，P=0.005）、回避的应对方式对心理弹性存在直接负向效应（ β=-0.216，P=0.007）、屈服的应对方式对心理弹性存在直接负向效应（ β=-0.431，P<0.001）；人格特征对心理弹性具有负向影响（ β=-0.606，P<0.001）。 结论 ICU身体约束 患者的心理弹性总体水平偏低。 社会支持、自我效能、应对方式、人格特征是ICU身体约束患者心理弹性的重要影响因素，可从这4项因素切入针对性干预提高身体约束患者的心理弹性水平。

关键词: 约束, 身体的, 弹性, 心理, 因素分析, 统计学, 危重病护理

Abstract: Objective To describe the level of psychological resilience in ICU physically restrained patients and to explore the influencing factors. Methods A general information questionnaire，Connor-Davidson Resilience Scale， Social Support Rating Scale，General Self-Efficacy Scale，Medical Coping Modes Questionnaire，and the Chinese short version of the Eysenck Personality Questionnaire were used to investigate 301 physically restrained patients admit- ted to the Department of Intensive Care Medicine of a tertiary class A hospital in Fujian Province from December 2021 to December 2022. Structural equation modelling was used to conduct the path analyses for the various influ- encing factors. Results Total psychological resilience score of ICU physically restrained patients was （53.17 ± 17.41），self-efficacy score was （25.16±7.96），social support score was （38.93±15.12），medical coping total score was （44.15±15.21），and Eysenck's personality total score was （23.68±2.98）. The total psychological resilience score of ICU physically restrained patients was positively correlated with the total social support score （r=0.585，P<0.001）， positively correlated with the total self-efficacy score （r=0.545，P<0.01），positively correlated with the confrontation dimension of the medical coping styles （r=0.602，P<0.01），and negatively correlated with the yielding and avoidance dimensions （r=-0.567，P<0.01；r=-0.627，P<0.01），positively correlated with the introversion and extroversion dimen- sions of personality traits（r=0.326，P<0.01），and negatively correlated with neuroticism，psychoticism，and dissimulation scores （r=-0.395，P<0.01；r=-0.338，P<0.01；r=-0.362，P<0.01）. The model was well-fitted，social support had direct and indirect effects on psychological resilience（r=0.546，P<0.001；r=0.267，P<0.001），self-efficacy had a direct effect onpsychological resilience （ r=0.218，P<0.001）. Confrontation coping style had a direct positive effect on psychological resilience（ r=0.415，P<0.001），avoidance coping style had a direct negative effect（ r=-0.216，P=0.007） and resignation coping style had a direct negative effect on psychological resilience （ r=-0.431，P<0.001）. Personality traits had a significant negative effect on psychological resilience（r=-0.606，P<0.001）。 Conclusion The overall level of psychologi- cal resilience of ICU physical restraint patients is low. Social support，self-efficacy，coping styles，and personality traits are important influencing factors on the psychological resilience of ICU physical restraint patients. Improving the level of their psychological resilience can be approached from these four factors.

Key words: Restraint, Physical, Resilience, Psychological, Factor Analysis, Statistical, Critical Care Nursing