目的 探讨维持性血液透析（maintenance hemodialysis，MHD）患者夫妻的疾病感知与二元应对的交互效应，为提升其二元应对水平提供依据。方法 2024年3-8月，采用便利抽样法选取上海市3所医院血透透析中心的MHD患者夫妻235对为研究对象，采用二元应对量表、简易疾病感知问卷等对其调查，构建主客体互倚模型分析二者之间的关系。结果 MHD患者夫妻的疾病感知评分为（42.77±7.09）分和（40.17±7.45）分，二元应对评分为（123.11±14.89）分和（125.57±18.20）分。主体效应显示，患者和配偶的疾病感知均负向预测自身的二元应对（β=-0.428、-0.324，均P＜0.001）；客体效应显示，患者的疾病感知负向预测配偶的二元应对（β=-0.294，P＜0.001），配偶的疾病感知负向预测患者的二元应对（β=-0.203，P＜0.001）。结论 MHD患者夫妻的疾病感知与二元应对交互影响，可开展疾病感知干预，提高其共同应对能力；重视配偶的客体效应，必要时实施干预，改善其生活质量。

Objective To investigate the interactive effects of illness perception and dyadic coping of maintenance hemodialysis (MHD) patients and their spouses，and to provide a basis for improving the level of binary coping.Methods From March to August 2024，235 couples of MHD patients from hemodialysis centers of 3 hospitals in Shanghai were selected by the convenience sampling method，and a survey was conducted using the binary coping scale，the simple disease perception questionnaire，etc.A subject-object interdependence model was constructed to analyze the relationship between the two.Results The illness perception scores of MHD patients and their spouses were (42.77±7.09) and (40.17±7.45)，respectively，while the dyadic coping scores were (123.11±14.89) and (125.57±18.20).In terms of actor effect，the illness perception of MHD patients and spouses negatively predicted their own dyadic coping (β=-0.428，β=-0.324，P＜0.001).In terms of partner effect，illness perception of MHD patients negatively predicted dyadic coping of spouses (β=-0.294，P＜0.001)，and illness perception of spouses negatively predicted dyadic coping of patients (β=-0.203，P＜0.001).Conclusions There is a dyadic interaction between illness perception and dyadic coping for MHD patients and their spouses.Disease perception intervention can be carried out to enhance the joint coping ability of MHD patients and their spouses.Importance should be attached to the object effect of the spouse and implement intervention when necessary to improve their quality of life.

R471；R473.5；R823

军委后勤部卫生局保健课题面上项目（22BJZ09）