目的 探讨希望和主观幸福感在癫痫患儿照顾者心理弹性与照顾负担间的链式中介作用及其性别差异，为减轻癫痫患儿照顾者照顾负担提供参考。方法 2023年9月至2024年3月，便利抽样法选取苏州市3所儿童医院癫痫患儿及其照顾者320对为研究对象，采用一般资料调查表、Zarit照顾者负担量表、心理弹性量表、Herth希望指数量表、幸福感指数量表对其进行调查。结果 癫痫患儿照顾者的照顾负担、心理弹性、希望和主观幸福感总分分别为（42.88±14.93）分、（49.60±10.15）分、（31.55±4.68）分、（8.93±2.01）分；心理弹性、希望、主观幸福感与照顾负担均呈负相关（r值分别为-0.74、-0.65和-0.72，均P＜0.01）。希望和主观幸福感在心理弹性与照顾负担间起链式中介作用，中介效应值为0.064，占总效应的7.94%。链式中介模型在癫痫患儿照顾者中存在性别差异。结论 癫痫患儿照顾者心理弹性既直接影响照顾负担，也能通过希望和主观幸福感产生间接作用，且这一链式中介模型存在性别差异。医务人员可构建干预支持网络增强照顾者心理弹性，提升其希望、主观幸福感水平，减轻照顾负担。

Objective To explore the serial mediating roles of hope and subjective well-being in the relationship between caregiver resilience and care burden in parents of children with epilepsy,and to examine gender differences,providing insights for alleviating their care burden.Methods From September 2023 to March 2024,320 pairs of children with epilepsy and their caregivers were recruited via convenience sampling from 3 children’s hospitals in Suzhou.Data were collected using the General Information Questionnaire,Zarit Burden Interview (ZBI),Connor-Davidson Resilience Scale (CD-RISC),Herth Hope Index (HHI),and Index of Well-being (IWB).Results The mean scores for caregiver burden,resilience,hope,and subjective well-being were (42.88±14.93),(49.60±10.15),(31.55±4.68),and (8.93±2.01),respectively.Care burden was negatively correlated with resilience (r=-0.74),hope (r=-0.65),and subjective well-being (r=-0.72) (all P＜0.01).Hope and subjective well-being played a serial mediating role between resilience and care burden,with an indirect effect of 0.064,accounting for 7.94% of the total effect.Gender differences were observed in the serial mediation model.Conclusions Caregiver resilience not only directly reduces care burden but also indirectly alleviates it through hope and subjective well-being,with gender-specific variations.Healthcare professionals should develop targeted intervention to enhance such resilience,foster hope and well-being,and ultimately reduce their burden.

R473.72

中国生命关怀协会人文护理专委会第二届人文护理科研项目（RW2024YB02），苏州市基础研究计划（医学应用基础研究）项目（SKYD2023124）