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慢性病老年患者自我管理水平的相关因素:一项路径分析

Factors associated with the level of self-management in elderly patients with chronic diseases: a pathway analysis.

作者信息

Cong Zhiyang, Huo Mingshu, Jiang Xing, Yu Hongyu

机构信息

School of Nursing, Jinzhou Medical University, No.40, Section 3, Songpo Road, Linghe District, Jinzhou City, Liaoning Province, P.R. China.

出版信息

BMC Geriatr. 2024 Apr 26;24(1):377. doi: 10.1186/s12877-024-04956-9.

Abstract

BACKGROUND

To analyze the effects and pathways of factors such as psychological capital, family functioning, and sources of meaning in life on the level of self-management in elderly patients with chronic diseases and to provide a basis for the development of relevant nursing interventions in the future.

METHODS

Convenience sampling was used to select elderly patients with chronic diseases who underwent medical checkups and consultations at three community hospitals in Jinzhou city from March 2023 to October 2023, and the self-designed General Information Questionnaire (GIS), Psychological Capital of the Elderly Scale (PCE), Family Functioning Index Questionnaire (APGAR), Sources of Meaning of Life Scale for Older Adults(SMSE), and Self-Management Behavior of Chronic Patients Scale (SMCS) were used. SPSS 26.0 was used for data entry, one-way analysis, Pearson correlation analysis, and multiple linear regression were used to analyze the data, and Amos 17.0 was used to construct the structural equation model.

RESULTS

A total of 355 elderly patients with chronic diseases were included, and their self-management score was 74.75 ± 12.93, which was moderate. The results of the influencing factor analysis showed that the influencing factors of the self-management level of elderly chronic disease patients were age, years of illness, psychological capital, family functioning, and sources of meaning in life (p < 0.05). Path analysis revealed that sources of meaning in life were a partial mediator of the relationship between psychological capital and self-management, with an effect value of 0.166 (95% CI: 0.042,0.391), accounting for 37.6% of the total effect; life meaning was a partial mediator of family functioning and self-management level, with an effect value of 0.231 (95% CI: 0.040,0.452), accounting for 54.0% of the total effect. accounting for 54.0% of the total effect.

CONCLUSION

The self-management of elderly patients with chronic diseases is intermediate. Healthcare professionals should actively implement holistic healthcare management measures from the family aspect to help patients understand the meaning of life and improve the level of patients' psychological capital to improve the self-management level of elderly patients with chronic diseases.

摘要

背景

分析心理资本、家庭功能、生活意义来源等因素对老年慢性病患者自我管理水平的影响及途径,为今后开展相关护理干预提供依据。

方法

采用便利抽样法,选取2023年3月至2023年10月在锦州市3家社区医院进行体检和咨询的老年慢性病患者,使用自行设计的一般资料问卷(GIS)、老年心理资本量表(PCE)、家庭功能指数问卷(APGAR)、老年人生活意义来源量表(SMSE)和慢性病患者自我管理行为量表(SMCS)。采用SPSS 26.0进行数据录入,运用单因素分析、Pearson相关分析和多元线性回归进行数据分析,采用Amos 17.0构建结构方程模型。

结果

共纳入355例老年慢性病患者,其自我管理得分为74.75±12.93,处于中等水平。影响因素分析结果显示,老年慢性病患者自我管理水平的影响因素为年龄、病程、心理资本、家庭功能和生活意义来源(p<0.05)。路径分析显示,生活意义来源是心理资本与自我管理关系的部分中介,效应值为0.166(95%CI:0.042,0.391),占总效应的37.6%;生活意义是家庭功能与自我管理水平关系的部分中介,效应值为0.231(95%CI:0.040,0.452),占总效应的54.0%。占总效应的54.0%。

结论

老年慢性病患者的自我管理处于中等水平。医护人员应从家庭层面积极实施整体健康管理措施,帮助患者理解生活意义,提高患者心理资本水平,以提高老年慢性病患者的自我管理水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8180/11055297/138a18640c20/12877_2024_4956_Fig1_HTML.jpg

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