社会支持在空巢老年患者急诊就诊时疾病不确定感与决策满意度间的中介效应 [中文引用][英文引用]

目的  探讨社会支持在空巢老年患者急诊就诊时疾病不确定感与决策满意度间的中介效应。方法  采用便利抽样法，于 2024 年 3 月— 9 月选取在江苏省某三级甲等综合医院急诊科就诊的 270 例空巢老年患者为研究对象，采用一般资料调查表、疾病不确定感量表（Mishel uncertainty in illness scale，MUIS）、社会支持量表（social support rating scale，SSRS）和患者决策满意度量表进行调查。采用 AMOS 24.0 软件构建中介效应结构方程模型验证社会支持在疾病不确定感与决策满意度间的中介效应，并采用 Bootstrap 法计算中介效应的 95%CI。结果  共 252 例患者完成研究。急诊就诊时空巢老年患者疾病不确定感总分（62.3±18.2）分，处于中等水平；社会支持总分（33.5±8.2）分，为中等水平；决策满意度总分为（63.9±10.2）分，为较高水平。疾病不确定感与社会支持呈负相关（r=-0.621，P<0.01），与决策满意度呈负相关（r=-0.685，P<0.01）；社会支持与决策满意度呈正相关（r=0.690，P<0.01）。疾病不确定感对决策满意度的直接效应为 -0.235，占总效应的 60.9%；社会支持在疾病不确定感与决策满意度间存在部分中介效应，中介效应为 -0.151，占总效应的 39.1%。结论  社会支持在空巢老年患者急诊就诊时疾病不确定感与决策满意度间发挥部分中介作用，提升社会支持水平有助于缓解疾病不确定感对决策满意度的负面影响。

Objective To examine the mediating effect of social support on illness uncertainty and decision satisfaction in emergency elderly patients who live alone. Methods Convenience sampling was used to recruit elderly patients living alone from the emergency departments at three Tier-IIIA hospitals in Jiangsu Province，between March and September 2024. Data were collected using a general information questionnaire，the Mishel uncertainty in illness scale（MUIS），social support rating scale（SSRS），and patient decision satisfaction scale. Structural equation modelling with Bootstrap method was used to test the mediating effect of social support between illness uncertainty and decision satisfaction. Results A total of 252 patients completed the study. The total mean score of illness uncertainty in the population was 62.3±18.2，indicating a medium level. The total mean score of social support was 33.5±8.2， also indicating a medium level. The total mean score of decision satisfaction was 63.9±10.2，indicating a medium-to-high level. Illness uncertainty was negatively correlated with social support（r=-0.621，P<0.01）and decision satisfaction（r=-0.685，P<0.01），while social support was positively correlated with decision satisfaction（r=0.690，P<0.01）. Mediation analysis showed that the direct effect of illness uncertainty on decision satisfaction was -0.235，accounting for 60.9% and social support played a partial mediating role between illness uncertainty and decision satisfaction，with an indirect effect of -0.151，accounting for 39.1% of the total effect. Conclusion Social support plays a partial mediating role between illness uncertainty and decision satisfaction in emergency elderly patients who live alone. Enhancing social support can alleviate the negative impact of illness uncertainty on decision satisfaction.