文献类型：期刊文献

中文题名：综合医院住院患者心理应激模型的初步构建

英文题名：Structuring one psychological stress model of inpatients in general hospital

作者：彭晓玲[1];黄海珊[2];李丹琳[3];胡慧[4]

第一作者：彭晓玲

机构：[1]湖南中医药大学第一临床医学院,长沙410007;[2]华中科技大学同济医学院附属同济医院神经内科;[3]甘肃中医学院护理学院;[4]湖北中医学院护理学院

第一机构：湖南中医药大学第一临床医学院,长沙410007

年份：2009

卷号：18

期号：7

起止页码：630

中文期刊名：中华行为医学与脑科学杂志

外文期刊名：Chinese Journal of Behavioral Medicine and Brain Science

收录：CSTPCD;;北大核心:【北大核心2008】；CSCD:【CSCD_E2011_2012】；

语种：中文

中文关键词：心理应激反应;中介因素;自我效能;结构方程模型

外文关键词：Psychological stress; Meditate factors; Self-efficacy; Structural equation model

摘要：目的对在综合性医院住院的患者应激源、中介机制、心理应激反应进行一个全面而整体的研究，建立一个住院患者心理应激反应及其影响因素关系的结构方程模型。方法采取分层一随机．整群抽样方法，抽取住院患者754例，使用相应量表调查住院患者的应激源、应对方式、自我效能、社会支持、人格和住院的心理反应。结果该结构方程模型拟合较好（χ2／df=3．24，CFI=0．96，IFI=0．96，GFI=0．95，RMSEA=0．056），进入构建结构方程模型的中介变量为：医院应激、社会支持、病程、经济、自我效能、神经质、内外向、回避、屈服，自我效能是一个重要的中介变量；医院应激可直接和间接作用于心理状况。结论可以通过提高和加强正性中介因素如自我效能，削弱和减轻负面中介因素如病程、神经质、回避、屈服等措施，降低或缓冲患者心理应激强度，提高患者心理健康水平。
Objective To structure one equation model on the relationship of the psychological stress response and its influential factors of inpatients. Methods This cross-sectional designed study used a stratified-random-cluster method to recruit 754 inpatients,who were asked to fill out a series of questionnaires assessing hospital stressor, social support, personality, coping style, self-efficacy, and stressful mental response. Statistic description, analysis of variance （ ANOVA ）, correlations, multiple linear regressions, confirmatory factor analysis, and structural equation model analysis （SEM） were conducted using SPSS 13.0 and LISRELS. 70. Results The final model showed good fit index（χ2/df = 3.24, CFI, IFI, GFI above 0.90, RMSEA = 0. 056）. Factors included in the SEM were social support, neuroticism, extraversion, avoidance, resignation, self-efficacy, course of disease and economic status. Self-efficacy significantly impacted mental status ;hospital stress can influence patients＇mental status directly and indirectly. Conclusion The psychological health status of inpatients can be improved by enhancing positive mediate factors such as self-efficacy and reducing such negative factors as avoidance coping style and disease duration and so on.