[1]张相醇,王安妮,管婷玉,等.照顾者照顾能力与失能老人抑郁:家庭弹性与心理弹性链式中介作用分析[J].军事护理,2023,40(06):43.[doi:10.3969/j.issn.2097-1826.2023.06.011]
 ZHANG Xiangchun,WANG Anni,GUAN Tingyu,et al.Caregivers' Caring Ability and Disabled Elderly's Depression:A Chain Mediating Effect Analysis of Family Resilience and Psychological Resilience[J].Nursing Journal Of Chinese People's Laberation Army,2023,40(06):43.[doi:10.3969/j.issn.2097-1826.2023.06.011]
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照顾者照顾能力与失能老人抑郁:家庭弹性与心理弹性链式中介作用分析
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《军事护理》[ISSN:2097-1826/CN:31-3186/R]

卷:
40
期数:
2023年06期
页码:
43
栏目:
论著
出版日期:
2023-06-15

文章信息/Info

Title:
Caregivers' Caring Ability and Disabled Elderly's Depression:A Chain Mediating Effect Analysis of Family Resilience and Psychological Resilience
文章编号:
2097-1826(2023)06-0043-06
作者:
张相醇王安妮管婷玉张雨怡孔韵怡孟佳乐沈梦圆魏争燕周倩如
(复旦大学 护理学院,上海 200023)
Author(s):
ZHANG XiangchunWANG AnniGUAN TingyuZHANG YuyiKong YunyiMENG JialeShen MengyuanWEI ZhengyanZHOU Qianru
(School of Nursing,Fudan University,Shanghai 200023,China)
关键词:
失能老人 抑郁 照顾者 照顾能力 家庭弹性 心理弹性 中介效应
Keywords:
disabled elderly depression caregiver caring ability family resilience psychological resilience mediating effect
分类号:
R473.2
DOI:
10.3969/j.issn.2097-1826.2023.06.011
文献标志码:
A
摘要:
目的 探讨失能老人的家庭弹性与心理弹性在照顾者照顾能力与老人抑郁情绪之间的中介作用,以期为居家失能老人抑郁机制研究和干预措施提供依据。方法 2021年7月至2022年3月,采用便利抽样法选取上海、安徽、甘肃三地的16个社区中居家失能老人及其照顾者(213对)为研究对象,采用一般资料问卷、家属照顾者照顾能力测量表(family caregiver task inventory-25,FCTI-25)、Walsh家庭弹性问卷中文版(Walsh family resilience questionnaire-C,WFRQ-C)、心理弹性量表(10-item Connor-Davidson resilience scale,CD-RISC-10)、患者健康问卷(patient health questionnaire-2,PHQ-2)对其调查。结果 家属照顾者FCTI-25平均评分为5(10,14)分,老年人WFRQ-C、CD-RISC-10及PHQ-2平均得分为98(87,107)分、(24.55±7.21)分和2(1,3)分。居家失能老人PHQ-2得分与照顾者FCTI-25得分呈正相关,与WFRQ-C、CD-RISC-10得分呈负相关(均P<0.01)。照顾者照顾能力对老人抑郁情绪的直接效应较大,占总效应的65.7%,并通过其家庭弹性和心理弹性发挥一定间接效应,占总效应的34.3%。结论 增强照顾者照顾能力可促进失能老人心理健康,同时也可从增强失能老人的家庭弹性和心理弹性的角度,来探索今后居家失能老人抑郁的干预方案。
Abstract:
Objective To explore the mediating effects of family resilience and psychological resilience on caregivers' caring ability and depression of the elderly,and to provide the basis for the study of depression mechanism and intervention measures for the disabled elderly at home.Methods From July 2021 to March 2022,convenience sampling method was adopted to select 16 communities in Shanghai,Anhui and Gansu as the research objects,including the disabled elderly at home and their caregivers(213 pairs).The family caregiver task inventory-25(FCTI-25),Walsh family resilience questionnaire-C(WFRQ-C),10-item Connor-Davidson resilience scale(CD-RISC-10)and patient health questionnaire-2(PHQ-2)were used for investigation.Results The mean FCTI-25 scores of caregivers were 5(10,14)points,and the mean WFRQ-C,CD-RISC-10 and PHQ-2 scores of the elderly were 98(87,107)points,(24.55±7.21)points and 2(1,3)points.The score of PHQ-2 was positively correlated with the score of FCTI-25,and negatively correlated with the score of WFRQ-C and CD-RISC-10(all P<0.01).Caregivers' caregiving ability has a large direct effect on depression of the elderly,accounting for 65.7% of the total effect,and exerts a certain indirect effect through family and psychological resilience,accounting for 34.3% of the total effect.Conclusions Enhancing the caregiver's caring ability can promote the psychological health of the disabled elderly.At the same time, from the perspective of enhancing the family resilience and psychological resilience of the disabled elderly,the future intervention programs can be explored.

参考文献/References:

[1] 裴青燕.中国老年人抑郁症状及影响因素分析[D].郑州:郑州大学,2019.
[2] GUREJE O,OGUNNIYI A,KOLA L,et al.Functional disability in elderly Nigerians:results from the Ibadan study of aging[J].J Am Geriatr Soc,2006,54(11):1784-1789.
[3] HSU H C.Physical function trajectories,depressive symptoms, and life satisfaction among the elderly in Taiwan[J].Aging Ment Health,2009,13(2):202-212.
[4] 陈昌惠.老年抑郁症流行病学[J].实用老年医学,2001,15(1):3-6.
[5] 民政部门户网站.三部门发布第四次中国城乡老年人生活状况抽样调查成果[EB/OL].[2022-04-19].http://jnjd.mca.gov.cn/article/zyjd/xxck/201610/20161000886652.shtml.
[6] LUO Y,SU B,ZHENG X.Trends and challenges for population and health during population aging-China,2015-2050[J].China CDC Wkly,2021,3(28):593-598.
[7] MICHELLE M,ROBINSON M F,SIMMONS S C,et al.Relations among co-occurring psychopathology in youth with autism spectrum disorder,family resilience,and caregiver coping[J/OL].[2022-04-19].https://www.sciencedirect.com/science/article/pii/S1750946721000787.DOI:10.1016/j.rasd.2021.101803.
[8] 黄素云,丁立东,康小燕,等.家庭主要照顾者照顾能力对脑卒中患者再入院的影响[J].实用临床医药杂志,2018,22(10):1-4.
[9] WAGNILD G M,YOUNG H M.Development and psychometric evaluation of the resilience scale [J].J Nurs Meas,1993,1(2):165-178.
[10]LU C,YUAN L,LIN W,et al.Depression and resilience mediates the effect of family function on quality of life of the elderly [J].Arch Gerontol Geriatr,2017(71):34-42.
[11]赵力慧,孙秋雪,郭玉成,等.脑卒中患者领悟社会支持与抑郁间的中介效应及心理弹性的调节效应[J].解放军护理杂志,2021,38(9):6-10.
[12]DANIEL S.Free a-priori sample size calculator for structural equation models[EB/OL].[2022-04-19]. https://www.danielsoper.com/statcalc/default.aspx.
[13]LOEHLIN J C,BEAUJEAN A A.Latent variable models:an introduction to factor, path,and structural equation analysis[M].Fifth Edition(5th ed.).New York: Routledge,2017:302-305.
[14]CLARK N M,RAKOWSKI W.Family caregivers of older adults:improving helping skills[J].Gerontologist,1983,23(6):637-642.
[15]LEE R L T,MOK E S B.Evaluation of the psychometric properties of a modified Chinese version of the caregiver task inventory--refinement and psychometric testing of the chinese caregiver task inventory:a confirmatory factor analysis[J].J Clin Nurs,2011,20(23-24):3452-3462.
[16]WALSH F.Family Resilience:a framework for clinical practice[J].Fam Process,2003,42(1):1-18.
[17]WANG A,LU J.Validation of the Chinese version of the walsh family resilience questionnaire [J].Fam Process,2023,62(1):368-386.
[18]CONNOR K M,DAVIDSON J R T.Development of a new resilience scale:the Connor-Davidson resilience scale(CD-RISC)[J].Depression and anxiety,2003,18(2):76-82.
[19]CAMPBELL-SILLS L,STEIN M B.Psychometric analysis and refinement of the Connor-Davidson resilience scale(CD-RISC):validation of a 10-item measure of resilience[J].J Traumatic Stress,2007,20(6):1019-1028.
[20]LIU Z W,YU Y,HU M,et al.PHQ-9 and PHQ-2 for screening depression in Chinese rural elderly[J/OL].[2022-04-19].https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0151042.DOI:10.1371/journal.pone.0151042.
[21]ZHAO X,LYNCH J G,CHEN Q.Reconsidering Baron and Kenny:myths and truths about mediation analysis[J].J Consum Res,2010,37(2):197-206.
[22]苏玥.中老年人抑郁状况及其影响因素分析[D].沈阳:辽宁大学,2019.
[23]PARK M,CHOI S,LEE S J,et al.The roles of unmet needs and formal support in the caregiving satisfaction and caregiving burden of family caregivers for persons with dementia[J].Int Psychogeriatr, 2018,30(4):557-567.
[24]TIMALSINA R,SONGWATHANA P,SAE-SIA W.Resilience and its associated factors among older disaster survivors[J].Geriatr Nurs,2021,42(6):1264-1274.
[25]SENDEN C,VANDECASTEELE T,VANDENBERGHE E,et al.The interaction between lived experiences of older patients and their family caregivers confronted with a cancer diagnosis and treatment: a qualitative study[J].Int J Nurs Stud,2015,52(1):197-206.
[26]王晓欢,王琳,程艳丽,等.白血病患儿家庭坚韧性及其影响因素研究[J].白血病·淋巴瘤,2019,28(12):753-757.
[27]徐瑜,迟俊涛,顾桂芹,等.慢性病患儿家庭弹性的研究进展[J].齐鲁护理杂志,2019,25(15):96-99.
[28]王梦雨,李家磊,郭虹,等.D型人格对老年人抑郁情绪的影响机制:社会支持和心理弹性的中介作用[J].中华老年多器官疾病杂志,2021,20(9):650-654.
[29]PETKUS A J,GUM A,WETHERELL J L.Thought suppression is associated with psychological distress in homebound older adults[J].Depress Anxiety,2012,29(3):219-225.
[30]陈玮,吴库生.乳腺癌术后患者心理弹性及其影响因素分析[J].中国医药科学,2017,7(20):24-29.
[31]LUTHAR S S,CICCHETTI D,BECKER B.The construct of resilience: a critical evaluation and guidelines for future work [J].Child Dev,2000,71(3):543-562.
[32]张文哲.运动对老年人抑郁的影响研究——心理弹性的中介作用[J].广州体育学院学报,2018,38(5):99-102.
[33]卢灿杰,周英,潘胜茂,等.心理弹性在老年抑郁与家庭关怀度间的中介效应研究[J].中国实用护理杂志,2016,32(35):2721-2727.
[34]朱眉华.困境与调适:乡城流动家庭的抗逆力研究[D].上海:上海大学,2013.
[35]KUKIHARA H,YAMAWAKI N,ANDO M,et al.The mediating effect of resilience between family functioning and mental well-being in hemodialysis patients in Japan:a cross-sectional design[J/OL].[2022-04-19].https://hqlo.biomedcentral.com/articles/10.1186/s12955-020-01486-x.DOI: 10.1186/s12955-020-01486-x.
[36]HAMALL K M,HEARD T R,INDER K J,et al.The child illness and resilience program(CHiRP):a study protocol of a stepped care intervention to improve the resilience and wellbeing of families living with childhood chronic illness[J/OL].[2022-04-19].https://bmcpsychology.biomedcentral.com/articles/10.1186/2050-7283-2-5.DOI:10.1186/2050-7283-2-5.

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备注/Memo

备注/Memo:
【 收稿日期 】2022-06-16【 修回日期 】2023-04-07
【 基金项目 】国家社会科学基金(20CSH016),上海市扬帆计划(20YF1401900),复旦大学护理双一流学科发展项目(FNSYL202008)
【 作者简介 】张相醇,博士在读,电话:021-64161784
【 通信作者 】王安妮,电话:021-64431803
更新日期/Last Update: 2023-06-15