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, 张宗敏, 余海燕, 等. 急性百草枯和敌草快口服中毒的临床对比分析. 贵州医药, 2018, 42(3): 334-335.
2.	孟辉. 急性敌草快中毒 708 例分析. 河北医科大学, 2022.
3.	孙艺青. 敌草快在 Wistar 大鼠中的毒性和单剂量毒代动力学研究. 河北医科大学, 2019.
4.	贾俊娥. 敌草快染毒犬早期血液灌流清除效果及早期脏器损害的初步研究. 山东大学, 2019.
5.	吴煜峥. 急性敌草快染毒大鼠肾脏及肺损伤的实验研究. 山东大学, 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, 王国钰, 訾金花. 颅脑损伤患者主要照顾人负担及生命质量的相关性分析. 山东医学高等专科学校学报, 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, 陆艳. 老年肠造口患者主要照顾者社会支持、心理韧性与照顾负担的相关性. 中国老年学杂志, 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, 杨小湜, 侯哲, 等. 护理者负担量表中文版的应用与评价. 中国公共卫生, 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, 张建新. 韧性(resilience)——在压力下复原和成长的心理机制. 心理科学进展, 2005, 13(5): 658-665.
16.	肖水源. 《社会支持评定量表》的理论基础与研究应用. 临床精神医学杂志, 1994, 4(2): 98-100.
17.	温忠麟, 叶宝娟. 有调节的中介模型检验方法: 竞争还是替补?. 心理学报, 2014, 46(5): 714-726.
18.	安欣, 李玉琢, 张丹, 等. 心理弹性在肺结核患者照顾者负担与生活质量间的中介效应. 中国防痨杂志, 2022, 44(1): 83-90.
19.	方杰, 张敏强, 邱皓政. 中介效应的检验方法和效果量测量: 回顾与展望. 心理发展与教育, 2012, 28(1): 105-111.
20.	赛亚杰, 姚吕鑫, 程玲, 等. 确诊初期肺癌患者照顾者的负担与患者生命意义的相关性分析. 昆明医科大学学报, 2023, 44(9): 171-175.
21.	金梦, 李丽, 姚金兰. 社会支持在肝癌患者主要照顾者生活质量与照顾负担间的作用. 解放军护理杂志, 2020, 37(5): 65-68, 75.
22.	张冬英, 杨嘉敏, 刘华. 老年痴呆病人照顾者心理弹性与照顾负担的相关性研究. 全科护理, 2018, 16(32): 3969-3973.
23.	刘日灿. 白血病化疗患儿主要照顾者照顾负担水平调查及其影响因素. 慢性病学杂志, 2022, 23(5): 733-735.
24.	赵珺. 早产儿母亲心理弹性与应对方式、社会支持的相关性. 中国健康心理学杂志, 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.	张璠, 孟鑫, 叶萍. 乳腺癌患者心理弹性及影响因素的研究. 中华护理杂志, 2015, 50(9): 1087-1090.
27.	苏盼, 张静平, 张杰, 等. 基于文献计量学的心理弹性研究现状和热点分析. 中国全科医学, 2016, 19(28): 3481-3485.
28.	吴晓云. 脑卒中患者的照顾者社会支持与心理弹性、应对方式相关性分析. 护理实践与研究, 2020, 17(11): 30-32.
29.	张欢, 周英. 癌症患者心理弹性的研究进展. 中国实用护理杂志, 2014, 30(11): 70-72.
30.	何苗, 张静. 癌症患者心理弹性影响因素及干预措施的研究进展. 中国护理管理, 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, 杨德森. 社会支持对身心健康的影响. 中国心理卫生杂志, 1987, 1(4): 183-187.
33.	汪苗, 徐红, 周海宴. 脑卒中偏瘫患者照顾者睡眠质量、照顾负担与心理弹性的关系. 护理学杂志, 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. 重型颅脑损伤患者照顾者照顾负担与心理弹性的相关性研究. 延吉: 延边大学, 2020.
36.	孙懿松, 徐琼峰, 顾嬿. 不同阶段永久性造口患者的照顾者护理负担的影响因素调查分析. 护士进修杂志, 2017, 32(16): 1456-1460.
37.	王璟, 王自盼, 岳树锦, 等. 大肠癌患者家庭照顾者照顾负担水平及其相关因素的系统评价. 中国护理管理, 2020, 20(1): 85-92.

1. 彭亮, 张宗敏, 余海燕, 等. 急性百草枯和敌草快口服中毒的临床对比分析. 贵州医药, 2018, 42(3): 334-335.
2. 孟辉. 急性敌草快中毒 708 例分析. 河北医科大学, 2022.
3. 孙艺青. 敌草快在 Wistar 大鼠中的毒性和单剂量毒代动力学研究. 河北医科大学, 2019.
4. 贾俊娥. 敌草快染毒犬早期血液灌流清除效果及早期脏器损害的初步研究. 山东大学, 2019.
5. 吴煜峥. 急性敌草快染毒大鼠肾脏及肺损伤的实验研究. 山东大学, 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, 王国钰, 訾金花. 颅脑损伤患者主要照顾人负担及生命质量的相关性分析. 山东医学高等专科学校学报, 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, 陆艳. 老年肠造口患者主要照顾者社会支持、心理韧性与照顾负担的相关性. 中国老年学杂志, 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, 杨小湜, 侯哲, 等. 护理者负担量表中文版的应用与评价. 中国公共卫生, 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, 张建新. 韧性(resilience)——在压力下复原和成长的心理机制. 心理科学进展, 2005, 13(5): 658-665.
16. 肖水源. 《社会支持评定量表》的理论基础与研究应用. 临床精神医学杂志, 1994, 4(2): 98-100.
17. 温忠麟, 叶宝娟. 有调节的中介模型检验方法: 竞争还是替补?. 心理学报, 2014, 46(5): 714-726.
18. 安欣, 李玉琢, 张丹, 等. 心理弹性在肺结核患者照顾者负担与生活质量间的中介效应. 中国防痨杂志, 2022, 44(1): 83-90.
19. 方杰, 张敏强, 邱皓政. 中介效应的检验方法和效果量测量: 回顾与展望. 心理发展与教育, 2012, 28(1): 105-111.
20. 赛亚杰, 姚吕鑫, 程玲, 等. 确诊初期肺癌患者照顾者的负担与患者生命意义的相关性分析. 昆明医科大学学报, 2023, 44(9): 171-175.
21. 金梦, 李丽, 姚金兰. 社会支持在肝癌患者主要照顾者生活质量与照顾负担间的作用. 解放军护理杂志, 2020, 37(5): 65-68, 75.
22. 张冬英, 杨嘉敏, 刘华. 老年痴呆病人照顾者心理弹性与照顾负担的相关性研究. 全科护理, 2018, 16(32): 3969-3973.
23. 刘日灿. 白血病化疗患儿主要照顾者照顾负担水平调查及其影响因素. 慢性病学杂志, 2022, 23(5): 733-735.
24. 赵珺. 早产儿母亲心理弹性与应对方式、社会支持的相关性. 中国健康心理学杂志, 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. 张璠, 孟鑫, 叶萍. 乳腺癌患者心理弹性及影响因素的研究. 中华护理杂志, 2015, 50(9): 1087-1090.
27. 苏盼, 张静平, 张杰, 等. 基于文献计量学的心理弹性研究现状和热点分析. 中国全科医学, 2016, 19(28): 3481-3485.
28. 吴晓云. 脑卒中患者的照顾者社会支持与心理弹性、应对方式相关性分析. 护理实践与研究, 2020, 17(11): 30-32.
29. 张欢, 周英. 癌症患者心理弹性的研究进展. 中国实用护理杂志, 2014, 30(11): 70-72.
30. 何苗, 张静. 癌症患者心理弹性影响因素及干预措施的研究进展. 中国护理管理, 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, 杨德森. 社会支持对身心健康的影响. 中国心理卫生杂志, 1987, 1(4): 183-187.
33. 汪苗, 徐红, 周海宴. 脑卒中偏瘫患者照顾者睡眠质量、照顾负担与心理弹性的关系. 护理学杂志, 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. 重型颅脑损伤患者照顾者照顾负担与心理弹性的相关性研究. 延吉: 延边大学, 2020.
36. 孙懿松, 徐琼峰, 顾嬿. 不同阶段永久性造口患者的照顾者护理负担的影响因素调查分析. 护士进修杂志, 2017, 32(16): 1456-1460.
37. 王璟, 王自盼, 岳树锦, 等. 大肠癌患者家庭照顾者照顾负担水平及其相关因素的系统评价. 中国护理管理, 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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