中国失独人群抑郁的基于韧性的多因素模型。
Resiliencebased multifactorial model of depression among people who lost an onlychild in China.
机构信息
Department of Basic Nursing, School of Nursing, Fudan University, Shanghai 200023.
School of Nursing, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong.
出版信息
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2021 Jan 28;46(1):75-83. doi: 10.11817/j.issn.1672-7347.2021.190301.
OBJECTIVES
There are almost one million families who lost their only child in China, and 65.6% of them had severe and long lasting depression and needed timely psycho-intervention. This study aims to explore the relationship among resilience and its influential factors, and to compare their effect on depression.
METHODS
A total of 212 only-child loss person in 9 administrative regions in Changsha were assessed by using Connor-Davidson Resilience Scale, Zung Self-rating Depression Scale, Simplified Coping Style Questionnaire, Simplified Eysenck Personality Questionnaire, Social Support Rating Scale, and General Self-efficacy Scale. A hypothetical model was tested based on Kumpfer resilience framework and stress-coping theory.
RESULTS
The influential factors of resilience were: positive coping (the total effect value was 0.480), support utilization (the total effect value was 0.359), neuroticism (the total effect value was -0.326), negative coping (the total effect value was 0.279), extraversion (the total effect value was 0.219), and objective support (the total effect value was 0.077). The process of individual-environment interaction showed a greater impact on resilience, which had a direct effect on depression (the total effect value was -0.344, 67.1%), and also indirect effect through self-efficacy (the total effect value was -0.169). The total effect of resilience accounted for 20.1% of the total effect of all variables.
CONCLUSIONS
Resilience mainly impacts depression directly, and can negatively predict depression in only-child loss parents. Resilience, located before self-efficacy, is a significant stress mediating variables. Personality traits and support utilization indirectly impact resilience via negative and positive coping. The key to promote the reorganization of resilience is the process of individual-environmental interaction, involving support utilization, positive coping, and some sorts of negative coping strategies, which plays an important role in developing a resilience intervention program and can improve the depression of the only-child loss person.
目的
中国约有 100 万个失去独生子女的家庭，其中 65.6%的人患有严重且持久的抑郁症，需要及时进行心理干预。本研究旨在探讨韧性及其影响因素之间的关系，并比较它们对抑郁的影响。
方法
采用Connor-Davidson 韧性量表、Zung 自评抑郁量表、简易应对方式问卷、简化艾森克人格问卷、社会支持评定量表和一般自我效能感量表，对长沙市 9 个行政区的 212 名独生子女丧亲者进行评估。基于 Kumpfer 韧性框架和应激应对理论，构建了一个假设模型。
结果
韧性的影响因素有：积极应对（总效应值为 0.480）、支持利用（总效应值为 0.359）、神经质（总效应值为-0.326）、消极应对（总效应值为 0.279）、外向性（总效应值为 0.219）和客观支持（总效应值为 0.077）。个体-环境相互作用的过程对韧性的影响更大，对抑郁有直接影响（总效应值为-0.344，占 67.1%），也通过自我效能感有间接影响（总效应值为-0.169）。韧性的总效应占所有变量总效应的 20.1%。
结论
韧性主要通过直接作用对抑郁产生影响，可以负向预测独生子女丧亲父母的抑郁。韧性位于自我效能之前，是一个重要的应激中介变量。人格特质和支持利用通过积极应对和消极应对间接影响韧性。促进韧性重组的关键是个体-环境相互作用的过程，包括支持利用、积极应对和某些类型的消极应对策略，这在制定韧性干预计划中起着重要作用，可以改善独生子女丧亲者的抑郁。
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