目的 探讨心理韧性在膀胱癌尿流改道腹壁造口患者自我护理能力与造口适应间的中介效应。方法 采用便利抽样法选取2021年5月至2022年8月在某院伤口造口门诊就诊的172例膀胱癌尿流改道腹壁造口患者为研究对象，采用一般资料调查表、心理韧性量表（Connor-Davidson resilience scale，CD-RISC）、自我护理能力实施量表（Lorensen’s self-care capability scale，LSCS）及造口适应量表（ostomy adjustment inventory-20，OAI-20）对其进行问卷调查。结果 膀胱癌尿流改道腹壁造口患者CD-RISC、LSCS及OAI-20总分分别为（50.69±10.52）分、（78.71±16.89）分、（40.05±10.60）分。经Pearson相关分析法分析，CD-RISC总分及各维度评分与LSCS总分及各维度评分呈正相关（均P＜0.05），CD-RISC总分及各维度评分与OAI-20总分及各维度评分呈正相关（均P＜0.05），LSCS总分及各维度评分与OAI-20总分及各维度评分呈正相关（均P＜0.05）。同时，CD-RISC在LSCS与OAI-20间有中介效应（0.333），占总效应的36.30%。结论 自我护理能力在直接影响膀胱癌尿流改道腹壁造口患者生活质量的同时，可通过心理韧性的中介作用影响患者的造口适应水平。

Objective To explore the mediating effects of psychological resilience on self-care capability and ostomy adjustment in patients with bladder cancer, who undergo urinary diversion abdominal wall stoma.Methods Convenient sampling method was used to select 172 bladder cancer patients who undergo urinary diversion abdominal wall stoma as the study objects,who visited the wound and stoma clinic in a hospital from May 2021 to August 2022 .The general information questionnaire,Connor- Davidson resilience scale (CD-RISC),Lorensen’s Self-Care Capability Scale (LSCS) and Ostomy Adjustment Inventory-20 (OAI-20) were used for investigation.Results The total scores of psychological resilience,self-care capability and ostomy adjustment were (50.69±10.52),(78.71±16.89) and (40.05±10.60) for patients with bladder cancer undergoing urinary redirection abdominal wall stoma.According to Pearson correlation analysis,the total score of psychological resilience and scores of each dimension were positively correlated with the total score of self-care ability and scores of each dimension (all P＜0.05).The total score of psychological resilience and the scores of all dimensions were positively correlated with the total score of ostomy adjustment and the scores of all dimensions (all P＜0.05).The total score of self-care capability and scores of each dimension were positively correlated with the total score of ostomy adjustment and scores of each dimension(all P＜0.05).Meanwhile,psychological resilience had a mediating effect between self-care capability and ostomy adjustment (0.333),accounting for 36.30% of the total effect.Conclusions The strength of self-care capability directly affects the quality of life of patients with bladder cancer undergoing urinary redirection abdominal wall stoma,and also influences the level of ostomy adjustment through the mediating role of psychological resilience.

R473.58

江西省卫生计生委科技计划（20203175）