目的 基于主-客体互倚模型(actor-partner interdependence model,APIM)了解血液透析患者及配偶的应对方式对双方负性情绪的影响，为制订有效的干预措施提供帮助。 方法 2021年12月至2022年6月，采用便利抽样法选取济南市2所三级甲等综合医院血液透析患者及配偶240对为研究对象，采用一般资料调查表、二元应对量表、医院焦虑和抑郁量表对其调查，通过主客体互倚模型， 分析血液透析患者和配偶二元应对对负性情绪的影响。 结果 血液透析患者二元应对总分为（113.83± 11.91）分，低于配偶总分；且患者的抑郁发生率高于配偶，差异均有统计学意义（均P＜0.05）。血液透析患者、配偶的二元应对总分分别与自身及配偶的负性情绪均呈负相关（均P＜0.01）。血液透析患者配偶的积极应对和消极应对均能预测自身的负性情绪（β=-0.29，0.14），即主体效应显著；血液透析患者及其配偶积极应对均能预测对方的负性情绪（β=-0.37，-0.65），即客体效应显著。 结论 血液透析患者及其配偶的应对方式与个体和客体的负性情绪密切相关，医护人员应及时发现和识别患者及配偶存在的负性情绪，将血液透析患者和配偶视为一个整体进行干预。

Objective To explore the influence of the coping styles of hemodialysis patients and their spouses on their negative emotions based on the Actor-partner Interdependence Model (APIM),and to provide reference for the development of effective intervention measures . Methods From December 2021 to June 2022，the convenience sampling method was used to select 240 pairs of hemodialysis patients and their spouses from 2 tertiary A hospitals in Ji ’nan ，and a survey was conducted with General information questionnaire，Dyadic Coping Scale，Hospital Anxiety and Depression Scale.The effects of dyadic coping on negative emotions in hemodialysis patients and their spouses was analyzed with APIM. Results The total score of dyadic coping of hemodialysis patients was (113.83±11.91)，which was lower than that of their spouses.The incidence of depression in the patients was higher than that in their spouses，and the differences were statistically significant (P＜0.05).The total scores of dyadic coping of hemodialysis patients and their spouses were negatively correlated with their own negative emotions and their spouses’ negative emotions (all P＜0.01).The positive and negative coping styles of the spouses of hemodialysis patients could predict their own negative emotions (β=-0.29，0.14)，that is，the subject effect was significant.The positive coping of hemodialysis patients and their spouses could predict the negative emotions of the other party (β=-0.37，-0.65)，that is，the object effect was significant. Conclusion The coping style of hemodialysis patients and their spouses is closely related to the negative emotions of individuals and objects.Medical staff should find and identify the negative emotions of patients and their spouses in time，and treat hemodialysis patients and their spouses as a whole to intervene.

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2021年山东省研究生教育质量提升计划和研究生教育创新计划项目（SDYKC21145）