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唇腭裂患儿照顾者焦虑的影响因素:基于素质-应激理论模型的路径分析。

The influential factors of anxiety among caregivers of children with CL/P: a path analysis based on diathesis-stress theoretical model.

机构信息

School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, 117 Nanjing North Street, Shenyang, Liaoning Province, 110002, China.

Department of Nursing, Shanxi Provincial People's Hospital, Taiyuan, China.

出版信息

BMC Public Health. 2024 Nov 14;24(1):3172. doi: 10.1186/s12889-024-20603-9.

Abstract

BACKGROUND

This study aims to validate a hypothesized model of the relationships between optimism, resilience, coping, parenting stress, perceived social support, and anxiety, as well as their influencing factors and consequences among caregivers of children diagnosed with cleft lip and/or palate (CL/P).

METHODS

A hypothesized model was proposed based on diathesis-stress theoretical model and existing literature. A convenience sample of two CL/P treatment centers in China was collected between April 2019 and July 2020. Various well-validated instruments were used to collect 248 valid data points. Descriptive statistics and correlations were computed to assess model fitness and path analysis was performed to investigate direct and indirect effects.

RESULTS

The results revealed that the average level of anxiety among caregivers of children suffering from CL/P was 3.00 (0.00,6.00). The fitness of the modified path model was evaluated using various measures, including χ2/df = 1.806, GFI = 0.989, RFI = 0.916, IFI = 0.990, CFI = 0.989, TLI = 0.960, RMSEA = 0.0570. Parenting stress had the greatest direct associated with anxiety, followed by perceived social support. Moreover, indirect relations to anxiety were observed for optimism, resilience, and coping, which were mediated through perceived social support and parenting stress.

CONCLUSION

In summary, this work suggests that both parenting stress and perceived social support in caregivers of children suffering from CL/P are associated with anxiety. Therefore, developing effective intervention approaches targeting key factors might potentially instrumental to alleviate anxiety.

摘要

背景

本研究旨在验证一个关于唇腭裂(CL/P)患儿照顾者的乐观、韧性、应对、育儿压力、感知社会支持与焦虑之间关系的假设模型,以及它们的影响因素和后果。

方法

基于素质-应激理论模型和现有文献提出了一个假设模型。于 2019 年 4 月至 2020 年 7 月在中国的两个 CL/P 治疗中心收集了一个方便样本。使用各种经过良好验证的工具收集了 248 个有效数据点。描述性统计和相关性分析用于评估模型拟合度,路径分析用于研究直接和间接效应。

结果

结果显示,CL/P 患儿照顾者的平均焦虑水平为 3.00(0.00,6.00)。使用多种指标评估了修正后的路径模型的拟合度,包括 χ2/df = 1.806、GFI = 0.989、RFI = 0.916、IFI = 0.990、CFI = 0.989、TLI = 0.960、RMSEA = 0.057。育儿压力与焦虑的直接关联最大,其次是感知社会支持。此外,还观察到乐观、韧性和应对与焦虑之间存在间接关系,这些关系通过感知社会支持和育儿压力来介导。

结论

总之,本研究表明,CL/P 患儿照顾者的育儿压力和感知社会支持与焦虑有关。因此,针对关键因素制定有效的干预措施可能有助于减轻焦虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e3db/11566460/728e7c8ecaea/12889_2024_20603_Fig1_HTML.jpg

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