Xu NeiLi, Zhao Shuai, Xue HongXia, Fu WenYi, Liu Li, Zhang TianQi, Huang Rui, Zhang Ning
The Second Clinical Academy of China Medical University, Shenyang, Liaoning, China.
The Department of Rheumatology at Shengjing Hospital of China Medical University, Shenyang, Liaoning, China.
PLoS One. 2017 Mar 14;12(3):e0173293. doi: 10.1371/journal.pone.0173293. eCollection 2017.
This study aimed to assess the association between perceived social support (PSS) and fatigue and the roles of hope, optimism, general self-efficacy and resilience as mediators or moderators on PSS-fatigue association among Rheumatoid Arthritis (RA) patients in China.
A multi-center, cross-sectional study was conducted withinpatients diagnosed with RA in northeast China, in which 305 eligible inpatients were enrolled. The Multidimensional Fatigue Inventory, Multidimensional Scale of Perceived Social Support, Herth Hope Index, Life Orientation Test Revised, General Self-Efficacy Scale and Ego-Resiliency Scale were completed. The associations of PSS, hope, optimism, general self-efficacy and resilience with fatigue and the moderating roles of these positive psychological constructs were tested by hierarchical linear regression. Asymptotic and resampling strategies were utilized to assess the mediating roles of hope, optimism, general self-efficacy and resilience.
The mean score of the MFI was 57.88 (SD = 9.50). PSS, hope, optimism and resilience were negatively associated with RA-related fatigue, whereas DAS28-CRP was positively associated. Only resilience positively moderated the PSS-fatigue association (B = 0.03, β = 0.13, P<0.01). Hope, optimism and resilience may act as partial mediators in the association between PSS and fatigue symptoms (hope: ab = -0.16, BCa 95%CI: -0.27, -0.03; optimism: ab = -0.20, BCa 95%CI: -0.30, -0.10; resilience: a*b = -0.12, BCa 95%CI: -0.21-0.04).
Fatigue is a severe symptom among RA patients. Resilience may positively moderate the PSS-fatigue association. Hope, optimism and resilience may act as partial mediators in the association. PSS, hope, optimism and resilience may contribute as effective recourses to alleviate fatigue, upon which PSS probably has the greatest effect.
本研究旨在评估感知社会支持（PSS）与疲劳之间的关联，以及希望、乐观、一般自我效能感和心理弹性在中国类风湿关节炎（RA）患者中作为PSS - 疲劳关联的中介或调节因素的作用。
在中国东北地区对确诊为RA的患者进行了一项多中心横断面研究，招募了305名符合条件的住院患者。完成了多维疲劳量表、感知社会支持多维量表、赫思希望指数、修订的生活取向测验、一般自我效能感量表和心理弹性量表。通过分层线性回归检验PSS、希望、乐观、一般自我效能感和心理弹性与疲劳的关联以及这些积极心理结构的调节作用。采用渐近和重抽样策略评估希望、乐观、一般自我效能感和心理弹性的中介作用。
MFI的平均得分为57.88（标准差 = 9.50）。PSS、希望、乐观和心理弹性与RA相关疲劳呈负相关，而DAS28 - CRP呈正相关。只有心理弹性对PSS - 疲劳关联起正向调节作用（B = 0.03，β = 0.13，P < 0.01）。希望、乐观和心理弹性可能在PSS与疲劳症状的关联中起部分中介作用（希望：ab = -0.16，BCa 95%CI：-0.27，-0.03；乐观：ab = -0.20，BCa 95%CI：-0.30，-0.10；心理弹性：a*b = -0.12，BCa 95%CI：-0.21 - 0.04）。
疲劳是RA患者的严重症状。心理弹性可能对PSS - 疲劳关联起正向调节作用。希望、乐观和心理弹性可能在该关联中起部分中介作用。PSS、希望、乐观和心理弹性可能作为缓解疲劳的有效资源发挥作用，其中PSS可能具有最大作用。
