目的 探讨老年高血压患者疾病影响程度在心理一致感与综合幸福感间的中介作用。方法 2022年11月至2023年5月，采用便利抽样法选取辽宁省锦州市两所三级甲等医院的537例老年高血压患者为研究对象，采用一般资料调查表、心理一致感量表、疾病影响程度量表和综合幸福感问卷对其进行调查。结果 老年高血压患者的心理一致感、疾病影响程度及综合幸福感得分分别为（54.91±15.55）、（252.59±12.05)、(52.22±8.63)分。相关性分析结果显示，老年高血压患者的综合幸福感与心理一致感呈正相关（r=0.82,P＜0.01），综合幸福感与疾病影响程度呈负相关（r=-0.56,P＜0.01），心理一致感与疾病影响程度呈负相关（r=-0.54,P＜0.01）；中介效应结果显示，疾病影响程度在心理一致感对综合幸福感的路径中产生部分中介作用，中介效应值为0.16，总效应值为0.77，中介效应占总效应的20.78%。结论 心理一致感既可直接增强老年高血压患者综合幸福感，也可通过降低疾病影响程度促进其综合幸福感。

Objective To explore the correlation between coping ability,disease impact degree and well-being of elderly patients with hypertension,construct a mediation effect model,and explore the mediating role of disease impact degree between coping ability and subjective well-being of patients.Methods From November 2022 to May 2023,537 elderly hypertensive patients from two tertiary A hospitals in Jinzhou,Liaoning Province were selected as the study objects by convenience sampling method.General data questionnaire,psychological congruence scale,disease impact scale and comprehensive happiness questionnaire were used to investigate them.Results The average score of coping ability of hypertensive patients was (54.91±15.55),the average score of disease impact degree was (252.59±12.05),and the average score of well-being was (52.22±8.63).The results of correlation analysis showed that well-being was positively correlated with coping ability (r=0.82,P＜0.01) and was negatively correlated with disease impact degree (r=-0.56,P＜0.01),and coping ability was negatively correlated with disease impact degree (r=-0.54,P＜0.01).The mediating effect showed that the degree of disease impact played a partial mediating role in the path of coping ability to well-being,with a mediating effect value of 0.16 and a total effect value of 0.77,accounting for 20.78% of the total effect.Conclusions Coping ability can have a direct effect on well-being,and the degree of disease impact plays a partial mediating role in the path of coping ability to well-being.

R473.59

中国老年学和老年医学学会“老年健康促进行动(2021-2025年)”立项项目(CAGG-2021-04-01) ；《基层全科医师健康管理能力培训体系的研究》立项项目(A-YXGP20210301-01)