心理弹性在腹膜透析患者焦虑抑郁与生活质量间的中介效应
Mediating Effect of Mental Resilience on Anxiety, Depression and Quality of Life in Pa-tients with Peritoneal Dialysis

目的：探讨腹膜透析患者焦虑抑郁、心理弹性及生活质量间的关系。方法：以2021年5月~2021年10月期间在某三甲医院肾病科随诊的腹膜透析患者为研究对象，按本次调查最大条目数26计算，样本量为最大条目数的5~10倍，考虑20%的无效问卷，样本量估算为156~312名。最终抽取腹膜透析患者183名，作为研究对象。运用SAS量表、SDS量表、心理弹性量表和生活质量量表进行问卷调查。结果：研究最终获得183份问卷，剔除23份无效问卷后，回收有效问卷160份，有效回收率为87.4%。160名腹膜透析患者SAS得分(39.80 ± 12.32)分，SDS得分(46.01 ± 13.40)分，心理弹性得分(63.79 ± 18.44)分，生活质量得分(54.34 ± 10.95)分；学历、婚姻状况、家庭月收入、医疗方式、是否发生过并发症是腹膜透析患者心理弹性的主要影响因素；皮尔逊相关性分析显示焦虑与心理弹性、生活质量存在负相关关系(r = ？0.592, P < 0.01; r = ？0.675, P < 0.01)；抑郁与心理弹性、生活质量存在负相关关系(r = ？0.651, P < 0.01; r = ？0.747, P < 0.01)；心理弹性与生活质量存在显著性正相关关系(r = 0.791, P < 0.01)；心理弹性在焦虑与生活质量之间起部分中介效应，部分效应占总效应的比例为31.40%；心理弹性在抑郁与生活质量之间起部分中介效应，部分效应占总效应的比例为46.19%。结论：应提高患者心理弹性水平，改善焦虑抑郁负性情绪，促进患者身心健康，进一步提高生活质量，使得腹膜透析患者更好地回归社会。
Objective: To explore the relationship between anxiety, depression, mental resilience and quality of life in patients with peritoneal dialysis. Methods: Patients with peritoneal dialysis who were fol-lowed up in the nephrology Department of a grade A hospital from May 2021 to October 2021 were selected as the research subjects. The maximum number of items in this survey was 26, to assure the sample size to be 5~10 times the maximum number of items, and considering 20% question-naires to be invalid, the sample size was estimated to be 156~312. The final sample size was 183. The researchers collected general information questionnaire, SAS, SDS, CD-RISC and WHOQOL-BREF. Results: Finally, 183 questionnaires were obtained. After removing 23 invalid questionnaires, the score of SAS of 160 subjects was 39.80 ± 12.32, the score of SDS was 46.01 ± 13.40, the score of CD-RISC was 63.79 ± 18.44, and the score of WHOQOL-BREF was 54.34 ± 10.95. Educational background, marital status, monthly family income, medical insurance payment method and complications were the main influencing factors of mental resilience in PD patients. Pearson correlation analysis showed that anxiety was negatively correlated with quality of life and mental resilience (r = ？0.592, P < 0.01; r = ？0.675, P < 0.01); depression was negatively correlated with quality of life and mental resilience (r = ？0.651, P < 0.01; r = ？0.747, P < 0.01); quality of life was positively correlated with mental resilience (r = 0.791, P < 0.01); Mental resilience played a partial mediating effect between anxiety/depression and quality of life (31.40%/46.19%). Conclu-sion: We should improve the level of mental resilience of patients, improve negative emotions, such as anxiety and depression, promote the physical and mental health, and improve the quality of life, better return to