Structural Equation Model For The Relationship Between Cognitive Reappraisal And Post-Traumatic Growth Among Corneal Transplantation Patients

Objectives 1.To investigate the status and influencing factors of post-traumatic growth（PTG）in corneal transplantation patients.2.Establish the structural equation model of the relationship between cognitive reappraisal and post-traumatic growth in patients with corneal transplantation,explore the main mediating variables and their path relationship that affect the relationship between cognitive reappraisal and post-traumatic growth in patients with corneal transplantation,and provide theoretical basis for clinical targeted intervention measures.Methods In this cross-sectional study,304 patients with corneal transplantation in three designated hospitals of Corneal donation in Anhui province from January 2020 to June2021 were selected by convenience sampling method.The corneal transplantation patients were investigated by general demographic data and disease data questionnaire,Chinese-Post-traumatic Growth Inventory（C-PTGI）,Connor-Davidson Resilience Scale 25（CD-RISC 25）,Perceived Social Support Scale（PSSS）and Emotional Regulation Questionnaire-Chinese Revised Version（ERQ-CRV）.SPSS22.0 was used to analyze the data,linear correlation and multiple linear regression were used to explore the influencing factors of PTG in corneal transplantation patients,and AMOS 23.0 was used to construct and verify the structural equation model.Results 1.The total PTG score of corneal transplantation patients was（39.14±11.37）.Univariate analysis showed that there were statistically significant differences in PTG levels among corneal transplantation patients with different age,gender,occupation,education level,per capita monthly income of family,primary disease diagnosis,disease course and postoperative best corrected visual acuity（P<0.05）.Multiple linear regression analysis showed that education level,marital status,occupation,per capita monthly income and primary disease diagnosis were the influencing factors of PTG（R~2=0.716,adjusted R2=0.697,F=37.771,P<0.001）.Linear correlation analysis showed that resilience,cognitive reappraisal,perceived social support and PTG were correlated in pairs.Cognitive reappraisal was positively correlated with PTG（r=0.620,P<0.05）,perceived social support was positively correlated with PTG（r=0.635,P<0.05）,resilience was positively correlated with PTG（r=0.686,P<0.05）,cognitive reappraisal was positively correlated with perceived social support（r=0.620,P<0.05）,cognitive reappraisal was positively correlated with resilience（r=0.821,P<0.05）,and perceived social support was positively correlated with resilience（r=0.824,P<0.05）.2.The structural equation model fitting of the relationship between cognitive reappraisal and PTG in corneal transplantation patients was good,X~2/df=1.866,RMSEA=0.054,GFI=0.928,AGFI=0.902,NFI=0.933,CFI=0.967,IFI=0.969,TLI=0.961.In the model,the total effect of cognitive reappraisal on PTG was 0.843,of which the direct effect was 0.292,and the indirect effect of perceived social support and resilience on PTG was 0.551.Conclusions The level of PTG in corneal transplantation patients was generally at a medium and low level,and education level,marital status,occupation,family per capita monthly income and primary disease diagnosis were the influencing factors of PTG.Structural equation model（SEM）shows that cognitive reappraisal can directly affect PTG,and also indirectly affect PTG through resilience and perceived social support.Resilience and social support are mediators between cognitive reappraisal and PTG.It is suggested that the PTG level of corneal transplantation patients needs to be further improved.The PTG level of corneal transplantation patients can be improved by improving their cognitive reappraisal,psychological resilience and perceived social support,thus improving their quality of life.