The mediating role of family expectations during the transition period after congenital heart disease surgery between migration stress and caregiver readiness
先心病术后过渡期家属希望水平在迁移应激与照顾者准备度之间的中介作用

摘要

目的 评估先心病患儿术后过渡期照顾者的希望水平在迁移应激与照顾者准备度之间的中介作用，并分析三者的相关结构及影响路径。方法 选取156名术后转出ICU的先心病患儿主要照顾者作为研究对象，使用迁移应激压力量表（FRSS）、照顾者准备度量表（CPS）及Herth希望量表（HHS）进行调查。统计分析包括t检验、方差分析、Pearson相关以及多元线性回归，并采用Bootstrap法检验中介效应。结果 迁移应激总分为（48.36±8.27）分，处于中等偏高水平；照顾者准备度总分为（21.84±4.13）分；希望水平总分为（32.71±5.22）分。迁移应激与准备度呈中度负相关（r＝−0.532，P＜0.001），与希望水平呈负相关（r＝−0.476，P＜0.001）。希望水平与准备度呈正相关（r＝0.589，P＜0.001）。回归分析显示迁移应激对准备度具有负向预测作用（β＝−0.328，P＜0.001），希望水平具有正向预测作用（β＝0.487，P＜0.001）。Bootstrap显示希望水平的间接效应为−0.205，95%CI为−0.301～−0.131，占总效应的38.2%，提示希望水平构成显著部分中介。结论 先心病患儿术后过渡期照顾者普遍存在较高迁移应激，且希望水平可部分缓解应激对准备度的负面影响。提升希望水平可作为优化过渡期家庭照护能力的关键环节。

Abstract

Objective To evaluate the mediating role of caregivers 'hope level in the transition period after surgery for children with congenital heart disease (CHD) between migration stress and caregivers' preparedness, and to analyze the structural relationships and influence pathways among these three factors.
Methods A longitudinal study was conducted at.
Methods 156 primary caregivers of children with congenital heart disease who were discharged from ICU after surgery were selected as subjects. The study used the following instruments: the Family Resilience Scale (FRSS), the Caregiver Preparation Scale (CPS), and the Herth Hope Scale (HHS). Statistical analyses included t-test, ANOVA, Pearson correlation, and multiple linear regression. The Bootstrap method was employed to test the mediating effect.
Results The total score of migration stress was (48.36±8.27), indicating a moderately high level. The caregiver's preparedness score was (21.84±4.13), and the hope level score was (32.71±5.22). Migration stress showed a moderate negative correlation with preparedness (r=−0.532, P<0.001) and a negative correlation with hope level (r=−0.476, P<0.001). Hope level exhibited a positive correlation with preparedness (r=0.589, P<0.001). Regression analysis revealed that migration stress negatively predicted preparedness (β=−0.328, P<0.001) and hope level positively predicted preparedness (β=0.487, P<0.001). Bootstrap analysis indicated that the indirect effect of hope level was −0.205 (95% CI: −0.301 to −0.131), accounting for 38.2% of the total effect, suggesting that hope level played a significant mediating role.
Conclusion   The caregivers of children with congenital heart disease in the postoperative transition period generally have high levels of migration stress, and the hope level can partially relieve the negative impact of stress on the preparedness. Improving the hope level can be a key link to optimize the family care ability in the transition period.