| ObjectiveTo investigate the status quo of stigma,resilience and quality of life in patients with chronic hepatitis B cirrhosis,to study the relationship between stigma,resilience and quality of life,and provide scientific basis for clinical nurses to implement psychological intervention measures for patients with chronic hepatitis B cirrhosis.MethodsWith the convenient sampling method,198 in-patients with chronic hepatitis B cirrhosis from the Department of Gastroenterology or the Department of Hepatology in a tertiary hospital in Qingdao were selected as the survey subjects from February 2019 to May 2021.The research tools included general information questionnaire,the social impact scale(SIS),connor-davidson resilience scale(CD-RISC),and the MOS item short from health survey(SF-36).The research data were analyzed by SPSS23.0 software.Diverse statistical methods were applied in this study: the counting data were described as frequency and percentage,continuous data were showed as X ± S,comparisons between groups were performed using independent sample t-test or one-way analysis of variance,Pearson(normal distribution)or Spearman(abnormal distribution)correlation analysis were used for correlation analysis;and SPSS process plug-in was used to analyze the mediating effect of psychological resilience between stigma and quality of life in patients.The level of statistical significance was α=0.05 and P value with bilateral probabilities.Results1.Sociodemographic characteristics of patients with chronic hepatitis B cirrhosis 131(66.2%)men and 67(33.8%)women were included in the study,and the average age was 59.56±10.56 years old,ranging from 34 to 89 years old.The duration of disease in the patients ranged from 1 to 30 years,with an average duration 4.63±4.49 years,and the duration of 139(70.2%)patients were less than 5 years.There were 190 married people(96.0%),and 89(44.9%)people with junior high school education in the research.142(71.7%)people had complete self-care ability,77(38.9%)patients were employees with medical insurance and 73(36.9%)patients were residents with resident medical insurance.The monthly average income of the families was 1001～3000 yuan for70(39.9%)patients and 3001～5000 yuan for 82(41.4%)patients,153(77.3%)patients did not have other chronic diseases in the current study.2.The status quo and influencing factors of stigma,resilience and quality of life of patients with chronic hepatitis B cirrhosisThe average score of stigma of patients with chronic hepatitis B cirrhosis was66.22±11.33.The results of single factor analysis of general data showed that the score of stigma was statistically significant in gender,disease duration,education level,current self-care situation,medical payment method,the average monthly family income and whether they had other chronic diseases(P<0.05).The resilience score of patients with chronic hepatitis B cirrhosis was 59.30±16.60.Single factor analysis of general data indicated that the score of resilience was statistically significant in gender,disease duration,education level,current self-care situation,medical payment method,and average monthly family income(P<0.05).The average quality of life score of patients with chronic hepatitis B cirrhosis was 92.60±17.18,which was lower than the domestic norm in eight dimensions.The results of single factor analysis showed that the score of quality of life was statistically significant in gender,age,education level,current self-care situation,and average monthly family income(P<0.05).3.Results of pearson correlation analysisThe total score of life quality of chronic hepatitis B cirrhosis patients had significant negative correlation with the score of stigma,social exclusion,economic discrimination,inner shame,and social isolation(P<0.01),and it had significant positive correlation with the total score of resilience,strength,tenacity,and optimism(P<0.01).In addition,all dimensions of quality of life(except for physical pain and role limitations due to physical health)were significantly correlated with the total score of stigma,social exclusion,economic discrimination,internal shame and social isolation(P<0.01)negatively and all dimension of quality of life was significantly correlated with the total score of resilience,strength,tenacity and optimism positively(P<0.01).4.Results of multiple linear regressionThe results comfirmed that age,current self-care status,economic discrimination,social isolation,strength,internal shame and stigma were significant predictors of quality of life(P<0.05).5.Results of the mediating effect analysisThe results of mediating effect analysis proved that the resilience of patients with chronic hepatitis B cirrhosis had a partial mediating effect between stigma and the quality of life.The psychological resilience accounted for 20.08% of the total effect of stigma on quality of life in patients with chronic hepatitis B cirrhosis.Conclusions:1.The stigma,resilience and quality of life of patients with chronic hepatitis B cirrhosis are at medium levels.2.There are significant differences in stigma of chronic hepatitis B cirrhosis patients in gender,course of disease,educational level,current self-care situation,drug payment methods,per capita monthly income of families,and whether they have other chronic diseases;There are significant differences in the resilience of patients with chronic hepatitis B cirrhosis in terms of gender,course of disease,educational level,current self-care situation,drug payment methods,and per capita monthly income of families;The differences in quality of life of patients with chronic hepatitis B cirrhosis are mainly reflected in gender,age,education level,current self-care situation,and per capita monthly income of families.3.The higher the level of stigma,the lower the level of resilience,and the worse the quality of life of patients with chronic hepatitis B cirrhosis.Resilience plays a partial mediating role between stigma and quality of life in patients with chronic hepatitis B cirrhosis. |
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