新疆医科大学学报

目的 分析老年重症肺炎(Severe pneumonia, SP)患者自我效能感与心理韧性的关系。方法 选取2019年10月至2022年10月重庆大学附属三峡医院收治的167例老年SP患者作为观察组，选取同期体检健康者167例作为对照组。均采用康纳-戴维森心理韧性量表(Connor-davidson resilience scale, CD-RISC)、一般自我效能感量表(General self-efficacy scale, GSES)调查心理韧性、自我效能感。比较两组CD-RISC评分与GSES评分相关性，观察组不同SP患者的CD-RISC评分；多元线性回归模型分析SP患者CD-RISC评分与GSES评分间独立关系；限制性立方样条模型分析GSES评分与CD-RISC评分间剂量-效应关系。结果 观察组CD-RISC评分、GSES评分均低于对照组(t/P=19.209/<0.001,20.406/<0.001);观察组CD-RISC评分与GSES评分呈高度正相关(r=0.733,P<0.001);对照组CD-RISC评分与GSES评分无相关性(r=0.286,P<0.001)。年龄、急性生理与慢性健康状况评分(Acute physiology and chronic health evaluationⅡ,APACHEⅡ)评分、合并基础疾病种类、GSES评分与老年SP患者CD-RISC评分不存在线性关系(P>0.05);家庭人均月收入、机械通气、合并呼吸衰竭、过去1年有住院史与患者CD-RISC评分存在线性关系(P<0.05);调整混杂因素后，老年SP患者GSES评分与CD-RISC评分呈非线性剂量-反应关系(χ²=17.859,P<0.001),当GSES评分<23分时，GSES评分与CD-RISC评分呈正相关(P<0.001)。结论 老年SP患者心理韧性受多种因素影响，在一定范围内，自我效能感与心理韧性存在量化关系，提高自我效能感可增加心理韧性。

Objective To analyze the relationship between self-efficacy and mental toughness in elderly patients with severe pneumonia(SP). Methods A total of 167 elderly SP patients from October 2019 to October 2022 were selected as observation group, and 167 healthy persons during the same period were selected as control group. Conner-Davidson resilience scale(CD-RISC) and General Self-Efficacy Scale(GSES) were used to investigate psychological resilience and self-efficacy, respectively. The CD-RISC scores of the different SP patients in observation group, control group and observation group were compared. Pearson correlation coefficient was used to analyze the correlation between CD-RISC score and GSES score in observation group and control group. Multiple linear regression model was used to analyze the independent relationship between CD-RISC score and GSES score in SP patients. The dose-effect relationship between GSES score and CD-RISC score was analyzed by restricted cubic spline model. Results The score of CD-RISC and GSES in observation group were lower than those in control group(t/P=19.209/<0.001, 20.406/<0.001). There was a high positive correlation between CD-RISC score and GSES score in observation group(r=0.733, P<0.001). There was basically no correlation between the CD-RISC score and GSES score in control group(r=0.286, P<0.001). There was no linear relationship between age, acute physiology and chronic health evaluation Ⅱ, APACHEⅡscores, types of combined underlying diseases, GSES scores and CD-RISC score in elderly SP patients(P>0.05), but there was linear relationship between family per capita monthly income, mechanical ventilation, combined respiratory failure, hospitalization history in the past 1 year and CD-RISC score(P<0.05). After adjusting for confounding factors, there was a nonlinear dose-response relationship between GSES score and CD-RISC score in elderly SP patients(χ²=17.859, P<0.001). When GSES score was <23, GSES score was positively correlated with CD-RISC score(P<0.001). Conclusion The mental toughness of elderly SP patients is affected by many factors. In a certain range, there is a quantitative relationship between self-efficacy and mental toughness, and improving self-efficacy can increase mental toughness.