目的 基于认知行为理论探讨维持性血液透析(maintenance hemodialysis，MHD)患者的自我效能感、益处发现和生活质量变量之间的关系，为提升患者心理健康和生活质量提供依据。方法 2023年4-9月，采取便利抽样法选取在上海市5所三级甲等医院血液净化中心接受治疗352例MHD患者为研究对象，使用一般人口学资料调查表、益处发现量表(benefit finding scale,BFS)、一般自我效能感量表(general self-efficacy scale,GSES)和SF-12生活质量量表(12-item short form health survey,SF-12)对其进行调查。结果 MHD患者的GSES得分为24.50(20.00,29.00) 分，BFS得分为 63.00(53.00,74.00) 分，SF-12得分为41.42(36.69,47.06) 分。MHD患者的生活质量与自我效能感、益处发现均呈正相关(均P＜0.01)；益处发现是自我效能感与生活质量的中介变量，起部分中介作用，中介效应值为0.062（95%CI:0.017~0.111），中介效应占总效应的22.71%。结论 自我效能感可通过增强益处发现影响MHD患者的生活质量，护理人员应注重提高患者的自我效能感，并积极引导其发现治疗的积极意义，以改善其生活质量。

Objective To explore the relationship among self-efficacy,benefit finding,and quality of life in patients undergoing maintenance hemodialysis (MHD) based on cognitive behavioral theory,and to provide a basis for improving their psychological well-being and quality of life.Methods From April to September 2023,a convenience sampling method was used to select MHD patients receiving treatment at hemodialysis centers in 5 tertiary A hospitals in Shanghai.They were surveyed using the General Demographic Information Questionnaire,the Benefit Finding Scale (BFS),the General Self-Efficacy Scale (GSES),and the 12-Item Short Form Health Survey (SF-12) quality of life scale.Results The GSES score for MHD patients was 24.50 (20.00,29.00),the BFS score was 63.00 (53.00,74.00),and the SF-12 score was 41.42 (36.69,47.06).The quality of life of MHD patients was positively correlated with both self-efficacy and benefit finding (both P＜0.01).Benefit finding was a mediator between self-efficacy and quality of life,playing a partial mediating role.The mediating effect value was 0.062 (95%CI：0.017~0.111),accounting for 22.71% of the total effect.Conclusions Self-efficacy can influence the quality of life of MHD patients by enhancing benefit finding.Nursing staff should focus on improving patients’ self-efficacy and actively guide them to discover the positive meaning of treatment to enhance their quality of life.

R47；R823