| 赵阳阳,李晶晶,梁新蕊,郁 姣,宋 雯,周晓冬.运动自我效能在维持性血液透析患者疲劳、运动恐惧与生存质量之间的中介效应[J].上海护理,2025,25(8): |
| 运动自我效能在维持性血液透析患者疲劳、运动恐惧与生存质量之间的中介效应 |
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| DOI： |
| 中文关键词: 维持性血液透析 运动自我效能 疲劳 运动恐惧 生存质量 中介效应 |
| 英文关键词: |
| 基金项目:长海医院2021年度教学成果立项培育项目（CHPY2021B16）；长海医院“长风破浪·海纳百川”人才工程“涌浪”名师培育计划 |
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| 中文摘要: |
| 目的 探讨维持性血液透析(maintenance hemodialysis, MHD)患者运动自我效能在疲劳、运动恐惧和生存质量之间的中介作用。方法 选取2022年8月至2023年2月在上海某三甲医院进行MHD治疗的242例血液透析患者。采用一般资料调查表、FACIT疲劳量表(Functional Assessment of Chronic Illness Therapy-Fatigue, FACIT-F)、TSK运动恐惧量表（Tampa Scale for Kinesiophobia,TSK）、运动自我效能量表（Exercise Self-Efficacy Scale，ESES）、SF-36生存质量量表 (short form 36 questionnaire, SF-36)生存质量量表进行相关问卷调查，分析MHD患者运动自我效能在疲劳、运动恐惧和生存质量之间的中介效应。相关性分析资料符合正态分布即采用Pearson 相关性分析，中介效应检验采用因果步骤法对变量进行中心化处理，再依次进行线性回归分析。以 P＜0. 05 为差异有统计学意义。结果 MHD患者存在运动疲劳和运动恐惧，不同特征患者之间的差异性具有统计学意义（P＜0.05）。从路径图中的回归系数可以发现，疲劳（β = -0.232, p < 0.001）和运动恐惧（β = -0.232, p < 0.001）对运动自我效能有显著的负向预测作用，表明随着疲劳和运动恐惧水平的上升，运动自我效能会随之下降；而运动自我效能对生存质量有显著的正向预测作用（β = 0.205, p < 0.001），表明随着运动自我效能的上升，生存质量也会随之上升。在加入中介变量运动自我效能之后，疲劳和运动恐惧依旧显著负向预测生存质量水平的变化，表明本研究中的中介模型为部分中介模型。运动自我效能在疲劳与生存质量间的中介效应值为-0.058，中介效应占总效应的11.35%；运动自我效能在运动恐惧与生存质量间的中介效应值为-0.035，中介效应占总效应的15.09%。结论 运动自我效能在MHD患者的疲劳、运动恐惧与生存质量之间的存在部分中介效应。MHD患者运动现状不容乐观，临床医护工作者需要重视对MHD患者的运动健康教育，帮助患者降低运动恐惧感等情绪对自我运动效能的影响，改善生存质量。 |
| 英文摘要: |
| Objective To explore the mediating role of exercise self-efficacy among fatigue, kinesiophobia, and quality of life in maintenance hemodialysis (MHD) patients. Methods A total of 242 MHD patients who received treatment in a tertiary hospital in Shanghai from August 2022 to February 2023 were selected. Relevant questionnaires, including the General Information Questionnaire, the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale, the Tampa Scale for Kinesiophobia (TSK), the Exercise Self-Efficacy Scale (ESES), and the Short Form 36 Questionnaire (SF-36) for quality of life, were used for investigation. The mediating effect of exercise self-efficacy among fatigue, kinesiophobia, and quality of life in MHD patients was analyzed. For correlation analysis, Pearson correlation analysis was used when the data conformed to the normal distribution. For the mediating effect test, the causal steps method was used to centralize the variables, followed by linear regression analysis. A P value less than 0.05 was considered statistically significant. Results MHD patients experienced exercise fatigue and kinesiophobia, and the differences among patients with different characteristics were statistically significant (P < 0.05). From the regression coefficients in the path diagram, it was found that fatigue (β = -0.232, p < 0.001) and kinesiophobia (β = -0.232, p < 0.001) had a significant negative predictive effect on exercise self-efficacy, indicating that as the levels of fatigue and kinesiophobia increased, exercise self-efficacy decreased. Exercise self-efficacy had a significant positive predictive effect on quality of life (β = 0.205, p < 0.001), suggesting that as exercise self-efficacy increased, the quality of life also improved. After adding the mediating variable of exercise self-efficacy, fatigue and kinesiophobia still significantly and negatively predicted the changes in the quality of life level, indicating that the mediating model in this study was a partial mediating model. The mediating effect value of exercise self-efficacy between fatigue and quality of life was -0.058, and the mediating effect accounted for 11.35% of the total effect. The mediating effect value of exercise self-efficacy between kinesiophobia and quality of life was -0.035, and the mediating effect accounted for 15.09% of the total effect. Conclusion Exercise self-efficacy plays a certain mediating role among fatigue, kinesiophobia, and quality of life in MHD patients. The exercise status of MHD patients is not optimistic. Clinical healthcare workers need to attach importance to the exercise health education for MHD patients, help patients reduce the impact of emotions such as kinesiophobia on their self-exercise efficacy, and improve their quality of life. |
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