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中文摘要: 目的 调查上海市城区失能老人主要照顾者应对方式，并分析其影响因素，为后期提供针对性干预方案提供依据。方法 于2016年7—12月采用便利抽样法对上海市浦东新区金杨社区440名失能老人的主要照顾者应用相关调查量表和自制一般人口社会学情况调查表进行调查。结果 本组患者面对维度评分（19.34±2.02）分，回避维度评分（14.87±3.30）分，屈服维度评分（10.23±1.88）分；面对维度评分低于常模，差异无统计学意义（P＞0.05），回避和屈服维度评分高于常模，差异有统计学意义（P＜0.01）。失能老人患慢性病数量、失能老人Barthel得分、照顾者健康状况及家庭月收入在面对、回避和屈服维度得分差异有统计学意义（P＜0.05）。照顾者年龄、与被照顾者关系及每日照顾时间在回避、屈服维度得分差异有统计学意义。失能时间、照顾者婚姻状况和照顾者职业状况在回避得分差异有统计学意义。自我效能和社会支持与面对维度呈正相关，与回避和屈服维度呈负相关；照顾负担与面对维度呈负相关，与回避、屈服维度呈正相关。多元线性回归分析结果显示，照顾负担、生活自理能力barthel指数和社会支持3个因素是医学应对方式面对维度影响因素；照顾者者年龄、生活自理能力barthel指数、社会支持和照顾负担4个因素是医学应对方式回避维度影响因素；照顾者自身健康状况、照顾负担、自我效能和社会支持4个变量是医学应对方式屈服维度影响因素。 结论 在未来的社区护理工作中，要综合评估、采取多种手段提高照顾者社会支持和自我效能感，降低照顾负担，提高照顾者应对水平，减少心理应激，促进康复。
Abstract:Objective To investigate the coping styles of primary caregivers of the disabled elderly in Shanghai urban area and analyze the influencing factors, so as to provide basis for the targeted intervention plans in the later period.Methods From July to December 2016, the main caregivers of 440 disabled elderly in Jinyang community, Pudong New District, Shanghai, application Related survey scaleand self-made general population sociology survey questionnaire . Results Results: The scores of face dimension, avoidance and yield dimensions were 19.34 ±2.02, 14.87 ±3.30 and 10.23 ±1.88, respectively.There was no significant difference in face dimension scores below the norm（P＞0.05）, the avoidance and yield dimension scores were higher than the norm, the difference was statistically significant (P＜0.01). There were statistically significant differences in the number of chronic diseases among disabled seniors, Barthel's score of disability elderly, health status of caregivers, and family monthly income in face, avoidance, and yield dimensions (P＜0.05).There was a statistically significant difference in the caregiver’s age, relationship with the care recipients, and daily care time in the avoidance and yield dimensions. The disability time, the caregiver's marital status, and the caregiver's occupational status had statistically significant differences in avoidance scores. Self-efficacy and social support were positively related to the dimension of the face, negatively related to the avoidance and submission dimensions; the burden of care is negatively related to the face dimension, and positively related to the avoidance and submission dimensions.Multiple linear regression analysis showed that the
care burden, barthel index , and social support were three factors influencing the face dimension scores of the medical coping style ; caregivers’age 、the barthel index、 social support and care burden were the factors
affecting the avoidance dimensions of medical coping styles ;the caregivers’ own health status, care burden, self-efficacy, and social support were the factors affecting the yield dimension of medical coping styles .Conclusion In the future community care work, comprehensive assessments and various means should be adopted to improve caregivers’social support and self-efficacy, reduce the care burden , improve the level of caregivers’response, reduce psychological stress, and promote rehabilitation.
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