目的：调查老年冠心病患者D型人格、应对方式、自我隐瞒与社会疏离的关系。方法：采用便利抽样法选取在湖南省3所三甲医院心内科住院的322名老年冠心病患者作为研究对象,采用一般资料调查表、一般疏离感量表、D型人格量表、医学应对方式问卷及自我隐瞒量表进行调查。结果：老年冠心病患者社会疏离得分为（39.69±11.20）分,D型人格得分为（24.17±9.49）分,应对方式中面对、回避和屈服维度得分分别为（15.76±5.81）分、（16.02±6.42）分和（10.74±3.81）分,自我隐瞒得分为（34.80±10.26）分。社会疏离、D型人格、回避应对、屈服应对和自我隐瞒两两呈正相关,面对应对与其他变量呈负相关。D型人格不仅可以直接正向预测社会疏离,也可以通过面对应对、回避应对、屈服应对或自我隐瞒的中介作用间接影响社会疏离,还可以通过回避应对和自我隐瞒的链式中介作用影响社会疏离,总中介效应占总效应的60.67%。结论：老年冠心病患者社会疏离处于中等偏高水平,应对方式和自我隐瞒在D型人格与社会疏离间起部分中介作用。医护人员可从调节患者D型人格、引导患积极应对以及降低患者自我隐瞒的角度构建干预方案,以改善老年冠心病患者的社会疏离水平。
Abstract
Objective To explore the relationship between type D personality, social isolation, coping style and self-concealment among elderly patients with coronary heart disease. Methods A total of 322 elderly patients with coronary heart disease in three grade A tertiary general hospital in Hunan were selected as subjects. Patient were surveyed using the General Alienation Scale (GAS), the Type D personality scale (DS-14), the Medical Coping Modes Questionnaire (MCMQ) and the Self‐Concealment Scale (SCS). Results The sample scored (39.69±11.20) on social isolation, (24.17±9.49) on type D personality, (15.76±5.81) on confrontation coping, (16.02±6.42) on avoidance coping, (10.74±3.81) on submission coping and (34.80±10.26) on self-concealment. There was positively correlation between social isolation, type D personality, avoidance coping, submission coping and self-concealment, while confrontation coping was negatively correlated with any of the other variables. The results of the mediating test showed that the type D personality in elderly patients with coronary heart disease directly and positively predict the social isolation, and indirectly affect separately through confrontation coping, avoidance coping, submission coping as well as self-concealment. Social isolation also could indirectly influenced type D personality through the chain mediating effect of avoidance coping and self-concealment. The total mediating effect accounted for 60.67% of the total effect. Conclusion Social isolation in elderly patients with coronary heart disease was in moderately high levels. Coping style and self-concealment play a partial mediating role between type D personality and social isolation. Medical staffs can improve the level of social isolation in elderly patients with coronary heart disease through the perspectives of changing patients' type D personality, guiding patients to adopt positive coping styles, and reducing patients' self-concealment.
关键词
社会疏离 /
D型人格 /
应对方式 /
自我隐瞒 /
冠心病 /
老年人 /
中介效应
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基金
湖南省自然科学基金面上项目“内在能力减退老年冠心病患者心脏康复依从性预测模型的构建及干预策略研究”（2023JJ30426）; 湖南省社会科学基金重点项目“基于‘时间银行’的社区智慧居家养老精准服务体系构建研究”（XSP20ZDI013）
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