目的 分析肺结核患者及其配偶照顾者心理痛苦、自我隐瞒与自我超越间的交互影响关系。方法 2022年2月至2024年1月，采用便利抽样法选取无锡市某三级甲等医院收治的肺结核患者及其配偶照顾者208对，采用一般调查问卷、心理痛苦温度计、自我隐瞒量表、自我超越量表对其进行调查，通过主客体互倚中介模型分析三者之间关系。结果 肺结核患者及配偶心理痛苦得分分别为（6.24±1.25）分、（5.73±1.16）分，自我隐瞒得分分别为为（36.41±5.76）分、（34.27±6.01）分，自我超越得分分别为为（40.47±8.12）分、（43.29±8.95）分。主体效应显示夫妻心理痛苦、自我隐瞒均能负向预测自身自我超越（均P＜0.05）。客体效应显示患者心理痛苦、自我隐瞒均能负向预测配偶自我超越，而配偶仅自我隐瞒能负向预测患者自我超越（均P＜0.05）。中介效应显示夫妻双方心理痛苦均能通过自身自我隐瞒对自身自我超越产生影响（均P＜0.05）；患者心理痛苦可以通过双方自我隐瞒对配偶自我超越产生影响（均P＜0.05）。结论 肺结核患者及其配偶照顾者心理痛苦、自我隐瞒对自我超越存在交互影响，临床应该从二元视角制订干预方案，以提高夫妻双方自我超越水平。

Objective To analyze the interactive effects of psychological distress and self-concealment on self-transcendence among tuberculosis patients and their spousal caregivers.Methods From February 2022 to January 2024,a convenience sampling method was used to select 208 pairs of tuberculosis patients admitted to a tertiary A hospital in Wuxi and their spousal caregivers.Surveys were conducted using a general questionnaire,the Psychological Distress Thermometer,the Self-Concealment Scale,and the Self-Transcendence Scale.The relationships among these variables were analyzed using an actor-partner interdependence mediation model.Results The scores of psychological distress of tuberculosis patients and their spouses were (6.24±1.25) and (5.73±1.16) respectively, and the scores of self-concealment were (36.41±5.76) and (34.27±6.01) respectively. The scores of self-transcendence were (40.47±8.12) and (43.29±8.95) respectively. The actor effects showed that both psychological distress and self-concealment negatively predicted self-transcendence in individuals (all P＜0.05) The partner effects showed that the patients’ psychological distress and self-concealment negatively predicted the spousal caregivers’ self-transcendence,while the spousal caregivers’ self-concealment negatively predicted the patients’ self-transcendence (all P＜0.05).The mediation effects showed that psychological distress in both partners could influence self-transcendence through self-concealment (all P＜0.05).Conclusions Psychological distress and self-concealment among tuberculosis patients and their spousal caregivers have interactive effects on self-transcendence.Clinical interventions should adopt a dyadic perspective to develop intervention programs aimed at improving self-transcendence in both partners.

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