| With the development of the construction industry and the popularity of modern transportation,the incidence of spinal cord injury is on the rise in recent years,most of which are young and middle-aged men.Spinal cord injury often leads to motorial,sensory and / or autonomic nerve dysfunction below the injured segment.Most of the patients with spinal cord injuries can not be cured,thus it is of great necessity to control the development of the disease through long-term rehabilitation treatment.During the process of long term treament,most of the patients are faced with a lot of troubles caused by long-term hospitalization,loss of labor ability,heavy economic burden and so on,resulting in the the possible negateve emotions experienced by the patients depression and anxiety.Those negative emotional feelings are negatively affecting the patients’ quality of life.At present,most studies have focused on the impact of patients’ negative psychology on their quality of life.However,it is hard for us to find related studies exploring spinal cord injury from the perspective of positive psychology.Based on what I know(to the extent of our knowledge)how to improve the quality of life of injured patients is is not discussed in many articles.It is clear that how to effectively stimulate and tap the potential advantages of patients,and analyze its role in improving the quality of life of patients,is an important issue to be solved.Gratitude and psychological capital are important research contents in positive psychology.Gratitude is an emotional state of gratitude and pleasure that occurs when society,nature,and others do favors to one.Psychological capital is a kind of positive psychological state that individuals show in their growth and developme nt.Studies have found that the improvement of the level of gratitude and psychological capital is conducive to the development of physical and mental health and the improvement of quality of life.However,the related research has not been reported in patients with spinal cord injury.Therefore,this research group changed the research perspective and introduced gratitude and psychological capital into the research category to explore the intermediary role of gratitude between psychological capital and qua lity of life in patients with spinal cord injury.Further verifying the effect of Gratitude intervention in patients with spinal cord injury.Objectives1.To understand the current situation and influencing factors of gratitude,psychological capital and quality of life in patients with spinal cord injury.2.To explore the mediating effect of gratitude on psychological capital and quality of life in patients with spinal cord injury.3.To determine the effect and reasons of Thanksgiving inter vention in improving the quality of life of patients with spinal cord injury.Methods1.Using Chinese version gratitude questionare(GQ-6),positive psychological capital questionare(PPQ-26)and C hinese version WHO quality of life scale(WHOQOL-BREF)as measuring tools,the data of gratitude,positive psychological capital and quality of life of 435 patients with spinal cord injury in three first-class hospitals in Xi’an from November 2018 to August 2019 were collected by cross-sectional study design.SPSS19.0software was used to analyze the data,including descriptive analysis(mean,standard deviation),independent sample t-test,one-way ANOVA,correlation analysis,multiple linear regression analysis and mediating effect analysis.These analyzing tools help to explore the current situation and influencing factors of gratitude,psychological capital and quality of life in patients with spinal cord injury.With the results of those statistical analyses,the mediating effect of gratitude between psychological capital and quality of life is clarified2.In a randomized controlled study design,120 patients with SCI were selected from the first part of the study from October to December 2019 and randomly divided into three groups with 40 patients in each group.The intervention group received gratitude diary intervention,the control group 1 received general diary intervention,and the control group2 did not are without.Three groups of patients were tested with gratitude questionare,psychological capital questionare and quality of life scale before intervention,4 weeks after intervention and 4 weeks after intervention.Chi-square test,one-way analysis of variance and repeated measures anova were used to evaluate the effect of gratitude intervention.3.Using the method of qualitative study,15 patients with spinal cord injury in the gratitude intervention group were interviewed 4 weeks after the end of the intervention.Colaizzi 7-step data analysis was used to analyze the patients’ participa tion experience and to explore the reasons why gratitude intervention affected the quality of life of patients with spinal cord injury.Results1.Mediating effect of gratitude on Psychological Capital and quality of Life in patients with Spinal Cord injuryIn this study,a total of 435 questionnaires were distributed and 410 were valid questionnaire.Gratitude: the gratitude score of patients with spinal cord injury was 28.11 ±4.75,which was lower than patients in other age groups such as college students and other patients.Age,educational background,per capita monthly income o f the family,complications and self-care ability of daily life are the variables that affect the level of gratitude of patients.Psychological capital: the total score of psychological capital of patients with spinal cord injury was 116.51±16.34,the total average score of items was 4.48 ±0.63.Which was ranked from high to low according to the average value of items in each dimension? The scores of psychological emotions like hope,optimism,resilience and self-efficacy were4.96 ±0.68,4.63 ±0.75,4.25 ±0.65 and 4.17 ±0.69 respectively.Age,gender,educational background,per capita monthly income of the family,course of disease,complications and self-care ability of daily life are the influencing factors of patients’ psychological capital.Quality of life: the total score of quality of life in patients with spinal cord injury was 46.92 ±3.56,the total average score of items is 1.96 ±0.15.From high to low,the scores in social domain,psychological field,physiological field a nd environmental field were 3.58±0.52,1.93 ±0.17,1.68 ±0.10 and 1.59 ±0.14 respectively.Gender,educational background,living place,per capita monthly income of the fa milyand self-care ability of daily life are the influencing factors of patients’ quality of life.Correlation Analysis of gratitude,Psychological Capital and quality of LifeThe score of gratitude in patients with spinal cord injury was positively correlated with the total score of psychological capital and all dimensions,among which the correlation between gratitude and total score of psychological capital was the highest(r =0.579,P < 0.01).Gratitude was positively correlated with the total score of quality of life and all dimensions,and the correlation between gratitude and the total score of quality of life was the highest(r = 0.755,P < 0.01).The total score of psychological capital and its dimensions were positively correlated with the total score of quality of life,and the correlation between the total score of psychological capital,and the total score of quality of life and social field was the highest(r = 0.629,P < 0.01).Analysis on the mediating effect of gratitudeThe results of stepwise regression analysis showed that gratitude played an intermediary role between psychological capital and quality of life in patients with spinal cord injury,which reduced the total effect of psychological capital on quality of life from0.120 to 0.063,and the mediating effect was 48%.2.Effect of intervention on gratitude,Psychological Capital and quality of Life in patients with Spinal Cord injury2.1 Comparison between groupsThe results of gratitude intervention group,control group 1(general diary group)and control group 2(blank control group)were compared at three time points before intervention,after 4 weeks of intervention and 4 weeks after the end of the inte rvention.Before interventionThere was no significant difference in the scores of gratitude,psychological capital and quality of life among gratitude intervention group,control group 1(general diary group)and control group 2(blank control group)(all P > 0.05).After 4 weeks of interventionComparison of gratitude scores among the three groups: the score of gratitude in the intervention group was significantly higher than that in the control group 1 and control group 2(P < 0.05),but there was no significant difference between the control group 1and the control group 2(P > 0.05).Comparison of the scores of psychological capital among the three groups: the total score and each dimension score of psychological capital in the intervention group were significantly higher than those in the control group 1 and control group 2(P < 0.05),but there was no significant difference between the control group 1 and the control group 2(P >0.05).Comparison of the scores of quality of life among the three groups: the total score of quality of life and the scores of physiological,psychological fields in the intervention group were significantly higher than those in the control group 1 and control group 2(P <0.05).There was no significant difference in the scores between control group 1 and control group 2(P > 0.05).4 weeks after the end of the interventionComparison of gratitude scores among the three groups: the gratitude score of intervention group was significantly higher than that of control group 1 and control group2(P < 0.05),but there was no significant difference between control group 1 and control group 2(P > 0.05).Comparison of the scores of psychological capital among the three groups: the total score of psychological capital and the dimensions of resilience,hope and optimism in the intervention group were significantly higher than those in the control group 1 and control group 2(P < 0.05),but there was no significant difference between the control group 1and the control group 2(P > 0.05).Comparison of the scores of quality of life among the three groups: the total scores of quality of life and the scores of physiological and psychological fields in the intervention group were significantly higher than those in the control group 1 and control group 2,and the difference was statistically significant(P < 0.05).There was no significant difference in the scores between control group 1 and control group 2(P > 0.05).2.2 Comparison in the groupsThe results of gratitude intervention group,control group 1(general diary group)and control group 2(blank control group)were compared before intervention,after 4 weeks of intervention and 4 weeks after the end of the intervention.In the intervention group: the score of gratitude after 4 weeks intervention was significantly higher than that before intervention and 4 weeks after intervention,and the difference was statistically significant(P < 0.05).The total score of psychological capital and the scores of psychological feelings like self-efficacy,hope and optimism were significantly higher than those before intervention and 4 weeks after the end of the intervention(P < 0.05).The total score of quality of life and the scores of physical,psychological and social dimensions were significantly higher than those before intervention and 4 weeks after the end of the intervention,and the difference was statistically significant(P < 0.05).There was no significant difference in the scores of gratitude,psychological capital and quality of life between control group 1 and control group 2 before intervention,after 4weeks of intervention and 4 weeks after the end of the intervention(P > 0.05).3.Analysis on the reasons for the improve ment of quality of Life by gratitude diary interventionThrough a semi-structured interview with 15 patients with spinal cord injury,it was found that gratitude diary can improve patients’ mood,promote the development of cognition and was very likely to play an undeniable role in transforming a patient’s belief,changing their attitude towards life.From these evidences,it was clear that gratidude diary can have a positive impact on the improvement of quality of life.Conclusion1.The gratitude of patients with spinal cord injury was at a low level as a whole.Age,education,per capita monthly income of family,complications and self-care ability of daily life were the influencing factors of gratitude in patients with spinal cord injury.2.The psychological capital of patients with spinal cord injury was in the middle level.Age,gender,educational background,per capita monthly income of family,clinical course of disease,complications and self-care ability of daily life were the influencing factors of psychological capital of patients with spinal cord injury.3.The quality of life of patients with spinal cord injury was at a low level.Gender,educational background,living place,per capita monthly income of family,complications and self-care ability of daily living were the influencing factors of quality of life in patients with spinal cord injury.4.There was a positive correlation between gratitude,psychological capital and quality of life in patients with spinal cord injury.Gratitude plays an intermediary role between psychological capital and quality of life.5.Gratitude diary intervention can promote the improvement of emotion,the change of cognition and belief and the change of life attitude of patients with spinal cord injury,and had a good immediate and delayed effect on improving gratitude,psychological capital and quality of life of patients with spinal cord injury. |
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