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    恶性淋巴瘤化疗病人疾病不确定感对健康促进行为的影响：心理韧性和健康赋权的链式中介作用

    Effect of the disease uncertainty on health promotion behavior in malignant lymphoma patients treated with chemotherapy: the chain mediating role of mental resilience and health empowerment

      摘要
    • 摘要:
      目的  探讨心理韧性和健康赋权在恶性淋巴瘤化疗病人疾病不确定感和健康促进行为的链式中介效应，为针对恶性淋巴瘤化疗病人实施有效的护理干预提供科学的理论指导。
      方法  选取210例恶性淋巴瘤化疗病人为研究对象，采用一般资料调查表，疾病不确定感量表(MUIS-A)、健康促进生活方式量表Ⅱ(HPLP-Ⅱ)、心理弹性量表(CD-RISC)和健康赋权量表(PPES)对其进行问卷调查。运用Pearson法分析心理韧性、健康赋权、疾病不确定感和健康促进行为之间的相关关系，采用Amos 21.0软件建立结构方程模型并进行中介效应检验。
      结果  恶性淋巴瘤化疗病人心理韧性得分(42.34±6.28)分，健康赋权得分(27.62±3.44)分，疾病不确定感得分(109.85±11.24)分，健康促进行为得分(118.34±12.76)分。Pearson分析结果显示：健康促进行为与疾病不确定感呈负相关关系(P < 0.05~P < 0.01)，与心理韧性、健康赋权均呈正相关关系(P < 0.05~P < 0.01)。心理韧性和健康赋权在疾病不确定感与健康促进行为的中介效应成立，总间接效应为35.37%，其中心理韧性的特定中介效应占17.57%，健康赋权的特定中介效应占13.38%，心理韧性-健康赋权的链式中介效应占4.42%。
      结论  心理韧性和健康赋权在疾病不确定感与健康促进行为间的链式中介效应成立，证实疾病不确定感可以通过调节心理韧性和健康赋权水平，影响健康促进行为。

       

      Abstract:
      Objective  To explore the chain mediating effects of mental resilience and health empowerment in the disease uncertainty and health promotion behavior in malignant lymphoma patients treated with chemotherapy, to provide the scientific theoretical guidance for the implementation of effective nursing intervention for patients.
      Methods  A total of 210 malignant lymphoma patients treated with chemotherapy were selected as the study subjects.The patients were investigated using the general data questionnaire, disease uncertainty scale, health promotion lifestyle scale Ⅱ, resilience scale and health empowerment scale.The correlations among the mental resilience, health empowerment, disease uncertainty and health promotion behavior were analyzed by Pearson analysis.The structural equation model was established by Amos 21.0 software, and the mediating effects were tested.
      Results  The mental resilience score, health empowerment score, disease uncertainty score and health promotion behavior score in malignant lymphoma patients treated with chemotherapy were (42.34±6.28) points, (27.62±3.44) points, (109.85±11.24) points and (118.34±12.76) points, respectively.The results of Pearson analysis showed that the health promotion behavior was negatively correlated with disease uncertainty(P < 0.05 to P < 0.01), and positively correlated with mental resilience and health empowerment(P < 0.05 to P < 0.01).The mediating effects of mental resilience and health empowerment on disease uncertainty and health promotion behavior were established.The total indirect effect was 35.37%, the specific mediating effect of mental resilience accounted for 17.57%, the specific mediating effect of health empowerment accounted for 13.38%, and the chain mediating effect of mental resilience and health empowerment accounted for 4.42%.
      Conclusions  The chain mediation effect of mental resilience and health empowerment on the relationship between disease uncertainty and health promotion behavior is established, which confirms that the disease uncertainty can affect health promotion behavior by regulating the level of mental resilience and health empowerment.

       

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