反刍思维在肾移植受者睡眠质量与社会支持间的中介效应分析

赵雯静; 张海玲; 杨秀木; 石珂; 管晓红

反刍思维在肾移植受者睡眠质量与社会支持间的中介效应分析

Analysis of the mediating effect of rumination on sleep quality and social support in kidney transplant recipients

摘要

摘要:
目的： 探究肾移植受者反刍思维、社会支持、睡眠质量间的关系。
方法： 采用便利抽样法选取210例肾移植受者，应用一般资料调查表、社会支持评定量表（SSRS）、匹兹堡睡眠质量指数量表（PSQI）、疾病多维度反刍思维量表（MRIS）进行问卷调查，分析肾移植受者反刍思维、社会支持、睡眠质量间的关系。
结果： 不同婚姻状况肾移植受者的SSRS得分差异有统计学意义（P ＜ 0.01）；不同年龄、移植术后时间肾移植受者的MRIS得分差异均有统计学意义（P ＜ 0.01和P ＜ 0.05）；不同年龄、婚姻状况、移植肾来源和移植术后时间肾移植受者的PSQI得分差异均有统计学意义（P ＜ 0.05 ~ P ＜ 0.01）。肾移植受者社会支持总分为（39.98 ± 7.49）分，反刍思维总分为（63.13 ± 29.24）分，睡眠质量总分为（7.20 ± 3.75）分。Pearson相关分析显示，肾移植受者社会支持与睡眠质量和反刍思维呈明显负相关关系（P ＜ 0.01），睡眠质量与反刍思维呈明显正相关关系（P ＜ 0.01）。结构方程模型结果显示，反刍思维在肾移植受者睡眠质量与社会支持之间起部分中介作用，占总效应的46.80%。
结论： 肾移植受者睡眠质量不佳，社会支持、反刍思维均与肾移植受者睡眠质量有关。医护人员应关注病人术后睡眠状况，通过采取相应措施增加社会支持来源、提升支持利用度，有利于降低病人反刍思维频率，提高病人睡眠质量。

Abstract:
Objective To explore the relationship between rumination, social support, and sleep quality in kidney transplant recipients.
Methods A total of 210 kidney transplant recipients were selected using convenient sampling. Questionnaire surveys were conducted using general demographic questionnaire, social support rating scale (SSRS), Pittsburgh sleep quality index (PSQI), and multidimensional rumination in illness scale (MRIS). The relationship between rumination, social support, and sleep quality among kidney transplant recipients was analyzed.
Results There was a statistically significant difference in the SSRS scores among kidney transplant recipients with different marital statuses (P ＜ 0.01). There were statistically significant differences in the MRIS scores among kidney transplant recipients with different ages and post-transplant time (P ＜ 0.01 and P ＜ 0.05). There were statistically significant differences in the PSQI scores among kidney transplant recipients with different ages, marital statuses, sources of transplanted kidneys, and post-transplant time (P ＜ 0.05 to P ＜ 0.01). The total score of social support in kidney transplant recipients was (39.98 ± 7.49) points, the total score of rumination was (63.13 ± 29.24) points, and the total score of sleep quality was (7.20 ± 3.75) points. Pearson correlation analysis showed that social support of kidney transplant recipients was significantly negatively correlated with sleep quality and rumination (P ＜ 0.01), while sleep quality was significantly positively correlated with rumination (P ＜ 0.01). The results of structural equation model indicated that rumination played a partial mediating effect between sleep quality and social support in kidney transplant recipients, accounting for 46.80% of the total effect.
Conclusions Kidney transplant recipients have poor sleep quality, and both social support and rumination are related to their sleep quality. Healthcare professionals should pay attention to patients' postoperative sleep status, and take appropriate measures to increase the sources of social support and enhance the utilization of support, which is beneficial to reducing the frequency of rumination and improving patients' sleep quality.

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