摘要
目的:调查大学生、社区居民、医务人员、住院患者4四类人群所受社会支持情况及所采取的应对方式,分析该4类人群社会支持水平与应对方式的关系。方法:①于2004-10/2005-09采取分层整群抽样方法对武汉市某大学、社区、医院、疾病预防控制中心的1500人进行问卷调查。为避免4类人群样本交叉,医务工作者主要为医院及疾病预防控制中心在职的医生、护士,不包括实习生,社区居民不含在校大学生,保留了中学生,患者为调查期间正在某医院住院者,剔除在校大学生。均对调查项目知情同意。②采用社会支持评定量表评估4类人群所受社会支持情况。该量表共10个条目,分为主观支持、客观支持和支持利用度3个维度计分,总分为10个条目计分之和,分数越高表示所受相应支持或支持利用度越高/好。采用应付方式问卷评估4类人群采取的应付方式。评分方法是采用分量表统计记分的形式,分量表分为解决问题、求助、合理化3项积极应对方式和自责、退避、幻想3项消极应对方式,分数越高,表示采用的相应应对方式越多。③对所得计分结果进行方差分析,并在其基础上作SNK检验;数据间相关性处理采用直线相关分析。结果:共收回填写完整、准确的问卷1369份。①社会支持评定量表评分:医务人员支持总分最高[(36.93±5.87)分]’大学生主观支持及客观支持得分均明显低于社区居民、医务人员、住院患者(F=18.702,27.911,P<0.01);而医务人员、大学生支持利用度明显高于社区居民和住院患者[(8.15±1.84),(7.82±1.85),(7.37±2.31),(7.69±2.07)分,F=9.266,P<0.01]。②应付方式分量表评分:四类人群应付方式问卷分量表中解决问题、合理化得分差异不明显(P>0.05);医务人员自责分明显低于大学生、社区居民、住院患者(F=10.820,P<0.01);大学生、医务人员、住院患者求助分明显高于社区居民(F=4.505,P<0.01);医务人员幻想及退避分均最低[(3.95±2.40),(4.37±2.25)分],与其他3类人群比较,差异明显(F=10.345,2.935,P<0.05～0.01)。4类人群积极应对方式评分结果差异不明显(P>0.05);医务人员消极应对方式得分明显低于大学生、社区居民及住院患者(F=9.398,P<0.01),后三类人群消极应对方式得分相近(P>0.05)。③社会支持与应对方式相关性:大学生社会支持评定量表中2个维度主观支持、支持利用度评分,医务人员3个维度评分,住院患者2个维度主观支持、客观支持评分与应对方式问卷中的积极应对方式评分呈显著正相关(r=0.128～0.325,P<0.05～0.01)。大学生社会支持评定量表中2个维度主观支持、客观支持评分,医务人员3个维度评分与应对方式问卷中的消极应对方式评分呈显著负相关(r=-0.126～-0.209,P<0.05～0.01)。结论:大学生、社区居民、医务人员、住院患者4类人群中医务人员的社会支持效果最好;大学生、医务人员对社会支持利用度高,他们主要采用,并且也能更好的采用积极的应对方式面对和解决问题;住院患者则常用消极的应对方式面对和解决问题。
AIM： To study the social support, coping style, and the correlation of the two in different populations （college students, community residents, medical personnel and inpatients）.
METHODS： ①From October 2004 to September 2005, 1 500 subjects were sampled from colleges, communities, hospitals and centers for disease control and prevention with stratified cluster sampling method and they all participated the survey on social support and coping style with the informed consents. In avoidance of the sample crossing, medical personnel was limited to the on-office physicians and nurses in the hospital and center for disease control and prevention; community residents included the students of middle schools and the patients were hospitalized in certain hospital. The above 3 populations rejected the college students on campus. ②There were 10 items in social support scale （SSS）, which was scored by 3 latitudes： subjective support, objective support, and the utility of the support. The total score was the adds of each score in 10 items, and the higher scores indicated the higher support and better utility of the support. Coping style questionnaire （CSQ） was composed of 6 sub-scales of solution, appeal, rationalization in positive style and self-reproach, fantasy, escape in negative style. The questionnaires were scored by the statistics of the subscales, and the higher scores indicated the more coping styles.③The scored results were tested by analysis of variance （ANOVA） and SNK test, the correlation of the data were analyzed by linear correlation analysis.
RESULTS： Finally 1 369 qualified questionnaires among 1 500 ones were kept for the analysis.①SSS scores： The medical personnel showed the highest total scores of the support [（36.93±5.87） points], and the college students presented obviously lower scores in subjective support and objective support, compared with other 3 populations （F=18.702, 27.911, P 〈 0.01）, and the utility of the support in the medical personnel and college students were significantly higher than those in community residents and inpatients [（8.15±1.84）, （7.82±1.85）, （7.37±2.31）, （7.69±2.07） points, F=9.266, P 〈 0.01]. ②CSQ scores： No statistical significance was found in the scores of solution and rationalization sub-scales of coping styles between four groups （P 〉 0.05）. The medical personnel scored the lowest in self-reproach with the significant differences （F=10.820, P 〈 0.01）; community residents scored the lowest in appeal with the significant differences （F =4.505, P 〈 0.01）; medical personnel scored the lowest in both fantasy and escape [（3.95±2.40）, （4.37±2.25） points], and the differences were of statistical significance （F=10.345, 2.935, P 〈 0.05-0.01）. There was no obvious difference in the scores of positive coping styles among four populations （P 〉 0.05）. The scores of negative coping styles were evidently lower in medical personnel than in other three populations （F=9.398, P 〈 0.01）, which were similar （P 〉 0.05）. ③Correlation of social support and coping style： The CSQ scores of positive coping styles had a notably positive correlation with the SSS scores of 2 latitudes （subjective support and the utility of the support） in college students, 3 latitudes in medical personnel and 2 lati- tudes （subjective support and objective support） in inpatients （r=0.128 -0.325, P 〈 0.05-0.01）. While there was the notably negative relationship between subjective support and objective support of college students as well as three latitudes of medical personnel with the CSQ scores of negative coping styles （r=-0.126 to -0.209, P 〈 0.05-0.01）.
CONCLUSION： Among the college students, community residents, medical personnel and inpatients, the medical personnel get the best social support effect. College students and medical personnel have the most efficient utility of support, and they mainly adopt the positive coping styles to face and solve the problems by solution and appeal, while fantasy is a common coping style among the inpatients, who face and solve the problems passively.
出处
《中国临床康复》
CSCD
北大核心
2006年第42期37-39,共3页
Chinese Journal of Clinical Rehabilitation
基金
湖北省卫生厅科研基金项目(JX2B71)
湖北省教育厅基金重点项目(2004D011)~~
