The mediating role of psychological resilience between social support and care burden of primary caregivers of patients with oral diquat poisoning_West China Medical Journal

Authors：

ZHENG Yingying ^1,2 , ZHANG Yanxia ^1,2 , SHI Jie ^1,2 , WEN Zixin ^1,2 , LIU Yuru ^1,2 , JIAN Xiangdong ¹ ,  KAN Baotian ^1,2

1. Department of Poisoning and Occupational Disease, Emergency Medicine, Qilu Hospital, Shandong University; Nursing Department, Qilu Hospital, Shandong University; Ji’nan, Shandong 250012, P. R. China;
2. School of Nursing and Rehabilitation, Shandong University, Ji’nan, Shandong 250012, P. R. China;

Corresponding?author：

KAN Baotian, Email: kanbaotian@163.com

Keywords：

Psychological resilience; primary caregiver; social support; care burden; mediating effect

DOI：

10.7507/1002-0179.202310145

Video：

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Objective To understand the current situation of the care burden of primary caregiver of patients with oral diquat poisoning, analyze its influencing factors, and analyze the mediating effect of psychological resilience in social support and care burden, so as to provide a theoretical basis for further clinical intervention. Methods The primary caregivers of patients with oral diquat poisoning who received treatment at Qilu Hospital of Shandong University between October 2019 and October 2021 were selected. The general information questionnaire, Zarit Burden Interview (ZBI), Connor-davidson Resilience Scale (CD-RISC), and Social Support Revalued Scale (SSRS) were used to investigate the primary caregivers of patients with oral diquat poisoning. The influencing factors of the care burden on primary caregivers were analyzed. Results A total of 218 patients and their primary caregivers were included. The age of the primary caregivers, whether they were an only child, physical condition, educational level, economic income, daily care time, patient’s condition, and patient’s urinary concentration of diquat were the influencing factors of ZBI. The SSRS score of the primary caregiver was 26.97±10.21, the CD-RISC score was 56.95±26.64, and the ZBI score was 52.95±16.06. The burden of care was negatively correlated with social support (r=?0.369, P<0.05), the burden of care was negatively correlated with psychological resilience (r=?0.467, P<0.05), and social support was positively correlated with psychological resilience (r=0.288, P<0.05). The role of psychological resilience in the influence of social support and care burden was partly mediated, accounting for 41.905%. Conclusions The level of social support and psychological resilience of the primary caregivers is low, and the burden of care is heavy. Psychological resilience plays an intermediary role in the social support and care burden of the primary caregivers of patients with oral diquat poisoning. Clinical staff can carry out targeted intervention to improve the level of social support and psychological resilience and reduce the care burden.

Citation： ZHENG Yingying, ZHANG Yanxia, SHI Jie, WEN Zixin, LIU Yuru, JIAN Xiangdong, KAN Baotian. The mediating role of psychological resilience between social support and care burden of primary caregivers of patients with oral diquat poisoning. West China Medical Journal, 2023, 38(11): 1666-1672. doi: 10.7507/1002-0179.202310145 Copy

1.	彭亮, 張宗敏, 余海燕, 等. 急性百草枯和敵草快口服中毒的臨床對比分析. 貴州醫藥, 2018, 42(3): 334-335.
2.	孟輝. 急性敵草快中毒 708 例分析. 河北醫科大學, 2022.
3.	孫藝青. 敵草快在 Wistar 大鼠中的毒性和單劑量毒代動力學研究. 河北醫科大學, 2019.
4.	賈俊娥. 敵草快染毒犬早期血液灌流清除效果及早期臟器損害的初步研究. 山東大學, 2019.
5.	吳煜崢. 急性敵草快染毒大鼠腎臟及肺損傷的實驗研究. 山東大學, 2018.
6.	Padmaja G, Vanlalhruaii C, et al. Quality of life of patients with cancer: a determinant of the quality of life of their family caregivers. J Cancer Educ, 2017, 32(3): 655-661.
7.	Schene AH, Tessler RC, Gamache GM. Instruments measuring family or caregiver burden in severe mental illness. Soc Psychiatry Psychiatr Epidemiol, 1994, 29(5): 228-240.
8.	程振秀, 王國鈺, 訾金花. 顱腦損傷患者主要照顧人負擔及生命質量的相關性分析. 山東醫學高等專科學校學報, 2022, 44(2): 114-116.
9.	Hasson-Ohayon I, Goldzweig G, Braun M, et al. Women with advanced breast cancer and their spouses: diversity of support and psychological distress. Psychooncology, 2010, 19(11): 1195-1204.
10.	Koller SH, Lisboa C. Brazilian approaches to understanding and building resilience in at-risk populations. Child Adolesc Psychiatr Clin N Am, 2007, 16(2): 341-356.
11.	徐夏燕, 陸艷. 老年腸造口患者主要照顧者社會支持、心理韌性與照顧負擔的相關性. 中國老年學雜志, 2022, 42(2): 471-474.
12.	Arai Y, Ikegami N. Health care systems in transition. Ⅱ. Japan, Part Ⅰ. An overview of the Japanese health care systems. J Public Health Med, 1998, 20(1): 29-33.
13.	王烈, 楊小湜, 侯哲, 等. 護理者負擔量表中文版的應用與評價. 中國公共衛生, 2006, 22(8): 970-972.
14.	Connor KM, Davidson JR. Development of a new resilience scale: the Connor‐Davidson Resilience Scale(CD‐RISC). Depress Anxiety, 2003, 18(2): 76-82.
15.	于肖楠, 張建新. 韌性(resilience)——在壓力下復原和成長的心理機制. 心理科學進展, 2005, 13(5): 658-665.
16.	肖水源. 《社會支持評定量表》的理論基礎與研究應用. 臨床精神醫學雜志, 1994, 4(2): 98-100.
17.	溫忠麟, 葉寶娟. 有調節的中介模型檢驗方法: 競爭還是替補?. 心理學報, 2014, 46(5): 714-726.
18.	安欣, 李玉琢, 張丹, 等. 心理彈性在肺結核患者照顧者負擔與生活質量間的中介效應. 中國防癆雜志, 2022, 44(1): 83-90.
19.	方杰, 張敏強, 邱皓政. 中介效應的檢驗方法和效果量測量: 回顧與展望. 心理發展與教育, 2012, 28(1): 105-111.
20.	賽亞杰, 姚呂鑫, 程玲, 等. 確診初期肺癌患者照顧者的負擔與患者生命意義的相關性分析. 昆明醫科大學學報, 2023, 44(9): 171-175.
21.	金夢, 李麗, 姚金蘭. 社會支持在肝癌患者主要照顧者生活質量與照顧負擔間的作用. 解放軍護理雜志, 2020, 37(5): 65-68, 75.
22.	張冬英, 楊嘉敏, 劉華. 老年癡呆病人照顧者心理彈性與照顧負擔的相關性研究. 全科護理, 2018, 16(32): 3969-3973.
23.	劉日燦. 白血病化療患兒主要照顧者照顧負擔水平調查及其影響因素. 慢性病學雜志, 2022, 23(5): 733-735.
24.	趙珺. 早產兒母親心理彈性與應對方式、社會支持的相關性. 中國健康心理學雜志, 2020, 28(6): 910-913.
25.	Smeenk FW, de Witte LP, van Haastregt JC, et al. Transmural care of terminal cancer patients: effects on the quality of life of direct caregivers. Nurs Res, 1998, 47(3): 129-136.
26.	張璠, 孟鑫, 葉萍. 乳腺癌患者心理彈性及影響因素的研究. 中華護理雜志, 2015, 50(9): 1087-1090.
27.	蘇盼, 張靜平, 張杰, 等. 基于文獻計量學的心理彈性研究現狀和熱點分析. 中國全科醫學, 2016, 19(28): 3481-3485.
28.	吳曉云. 腦卒中患者的照顧者社會支持與心理彈性、應對方式相關性分析. 護理實踐與研究, 2020, 17(11): 30-32.
29.	張歡, 周英. 癌癥患者心理彈性的研究進展. 中國實用護理雜志, 2014, 30(11): 70-72.
30.	何苗, 張靜. 癌癥患者心理彈性影響因素及干預措施的研究進展. 中國護理管理, 2015, 15(7): 880-883.
31.	Han Y, Hu D, Liu Y, et al. Coping styles and social support among depressed Chinese family caregivers of patients with esophageal cancer. Eur J Oncol Nurs, 2014, 18(6): 571-577.
32.	肖水源, 楊德森. 社會支持對身心健康的影響. 中國心理衛生雜志, 1987, 1(4): 183-187.
33.	汪苗, 徐紅, 周海宴. 腦卒中偏癱患者照顧者睡眠質量、照顧負擔與心理彈性的關系. 護理學雜志, 2017, 32(9): 56-59.
34.	Higginson IJ, Gao W. Caregiver assessment of patients with advanced cancer: concordance with patients, effect of burden and positivity. Health Qual Life Outcomes, 2008, 6: 42.
35.	尹娉. 重型顱腦損傷患者照顧者照顧負擔與心理彈性的相關性研究. 延吉: 延邊大學, 2020.
36.	孫懿松, 徐瓊峰, 顧嬿. 不同階段永久性造口患者的照顧者護理負擔的影響因素調查分析. 護士進修雜志, 2017, 32(16): 1456-1460.
37.	王璟, 王自盼, 岳樹錦, 等. 大腸癌患者家庭照顧者照顧負擔水平及其相關因素的系統評價. 中國護理管理, 2020, 20(1): 85-92.

1. 彭亮, 張宗敏, 余海燕, 等. 急性百草枯和敵草快口服中毒的臨床對比分析. 貴州醫藥, 2018, 42(3): 334-335.
2. 孟輝. 急性敵草快中毒 708 例分析. 河北醫科大學, 2022.
3. 孫藝青. 敵草快在 Wistar 大鼠中的毒性和單劑量毒代動力學研究. 河北醫科大學, 2019.
4. 賈俊娥. 敵草快染毒犬早期血液灌流清除效果及早期臟器損害的初步研究. 山東大學, 2019.
5. 吳煜崢. 急性敵草快染毒大鼠腎臟及肺損傷的實驗研究. 山東大學, 2018.
6. Padmaja G, Vanlalhruaii C, et al. Quality of life of patients with cancer: a determinant of the quality of life of their family caregivers. J Cancer Educ, 2017, 32(3): 655-661.
7. Schene AH, Tessler RC, Gamache GM. Instruments measuring family or caregiver burden in severe mental illness. Soc Psychiatry Psychiatr Epidemiol, 1994, 29(5): 228-240.
8. 程振秀, 王國鈺, 訾金花. 顱腦損傷患者主要照顧人負擔及生命質量的相關性分析. 山東醫學高等專科學校學報, 2022, 44(2): 114-116.
9. Hasson-Ohayon I, Goldzweig G, Braun M, et al. Women with advanced breast cancer and their spouses: diversity of support and psychological distress. Psychooncology, 2010, 19(11): 1195-1204.
10. Koller SH, Lisboa C. Brazilian approaches to understanding and building resilience in at-risk populations. Child Adolesc Psychiatr Clin N Am, 2007, 16(2): 341-356.
11. 徐夏燕, 陸艷. 老年腸造口患者主要照顧者社會支持、心理韌性與照顧負擔的相關性. 中國老年學雜志, 2022, 42(2): 471-474.
12. Arai Y, Ikegami N. Health care systems in transition. Ⅱ. Japan, Part Ⅰ. An overview of the Japanese health care systems. J Public Health Med, 1998, 20(1): 29-33.
13. 王烈, 楊小湜, 侯哲, 等. 護理者負擔量表中文版的應用與評價. 中國公共衛生, 2006, 22(8): 970-972.
14. Connor KM, Davidson JR. Development of a new resilience scale: the Connor‐Davidson Resilience Scale(CD‐RISC). Depress Anxiety, 2003, 18(2): 76-82.
15. 于肖楠, 張建新. 韌性(resilience)——在壓力下復原和成長的心理機制. 心理科學進展, 2005, 13(5): 658-665.
16. 肖水源. 《社會支持評定量表》的理論基礎與研究應用. 臨床精神醫學雜志, 1994, 4(2): 98-100.
17. 溫忠麟, 葉寶娟. 有調節的中介模型檢驗方法: 競爭還是替補?. 心理學報, 2014, 46(5): 714-726.
18. 安欣, 李玉琢, 張丹, 等. 心理彈性在肺結核患者照顧者負擔與生活質量間的中介效應. 中國防癆雜志, 2022, 44(1): 83-90.
19. 方杰, 張敏強, 邱皓政. 中介效應的檢驗方法和效果量測量: 回顧與展望. 心理發展與教育, 2012, 28(1): 105-111.
20. 賽亞杰, 姚呂鑫, 程玲, 等. 確診初期肺癌患者照顧者的負擔與患者生命意義的相關性分析. 昆明醫科大學學報, 2023, 44(9): 171-175.
21. 金夢, 李麗, 姚金蘭. 社會支持在肝癌患者主要照顧者生活質量與照顧負擔間的作用. 解放軍護理雜志, 2020, 37(5): 65-68, 75.
22. 張冬英, 楊嘉敏, 劉華. 老年癡呆病人照顧者心理彈性與照顧負擔的相關性研究. 全科護理, 2018, 16(32): 3969-3973.
23. 劉日燦. 白血病化療患兒主要照顧者照顧負擔水平調查及其影響因素. 慢性病學雜志, 2022, 23(5): 733-735.
24. 趙珺. 早產兒母親心理彈性與應對方式、社會支持的相關性. 中國健康心理學雜志, 2020, 28(6): 910-913.
25. Smeenk FW, de Witte LP, van Haastregt JC, et al. Transmural care of terminal cancer patients: effects on the quality of life of direct caregivers. Nurs Res, 1998, 47(3): 129-136.
26. 張璠, 孟鑫, 葉萍. 乳腺癌患者心理彈性及影響因素的研究. 中華護理雜志, 2015, 50(9): 1087-1090.
27. 蘇盼, 張靜平, 張杰, 等. 基于文獻計量學的心理彈性研究現狀和熱點分析. 中國全科醫學, 2016, 19(28): 3481-3485.
28. 吳曉云. 腦卒中患者的照顧者社會支持與心理彈性、應對方式相關性分析. 護理實踐與研究, 2020, 17(11): 30-32.
29. 張歡, 周英. 癌癥患者心理彈性的研究進展. 中國實用護理雜志, 2014, 30(11): 70-72.
30. 何苗, 張靜. 癌癥患者心理彈性影響因素及干預措施的研究進展. 中國護理管理, 2015, 15(7): 880-883.
31. Han Y, Hu D, Liu Y, et al. Coping styles and social support among depressed Chinese family caregivers of patients with esophageal cancer. Eur J Oncol Nurs, 2014, 18(6): 571-577.
32. 肖水源, 楊德森. 社會支持對身心健康的影響. 中國心理衛生雜志, 1987, 1(4): 183-187.
33. 汪苗, 徐紅, 周海宴. 腦卒中偏癱患者照顧者睡眠質量、照顧負擔與心理彈性的關系. 護理學雜志, 2017, 32(9): 56-59.
34. Higginson IJ, Gao W. Caregiver assessment of patients with advanced cancer: concordance with patients, effect of burden and positivity. Health Qual Life Outcomes, 2008, 6: 42.
35. 尹娉. 重型顱腦損傷患者照顧者照顧負擔與心理彈性的相關性研究. 延吉: 延邊大學, 2020.
36. 孫懿松, 徐瓊峰, 顧嬿. 不同階段永久性造口患者的照顧者護理負擔的影響因素調查分析. 護士進修雜志, 2017, 32(16): 1456-1460.
37. 王璟, 王自盼, 岳樹錦, 等. 大腸癌患者家庭照顧者照顧負擔水平及其相關因素的系統評價. 中國護理管理, 2020, 20(1): 85-92.

West China Medical Journal

The mediating role of psychological resilience between social support and care burden of primary caregivers of patients with oral diquat poisoning

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