ABSTRACT
Background: Previous research has shown that medical coping modes are associated with resilience in cardiovascular disease patients. However, postoperatively, the mechanism underlying this association in Stanford type A aortic dissection patients is poorly understood. Objective: This study investigated the mediating effects of social support and self-efficacy on the relationship between medical coping modes and resilience in Stanford type A aortic dissection patients postoperatively. Methods: We assessed 125 patients after surgery for Stanford type A aortic dissection using the Medical Coping Modes Questionnaire, the General Self-Efficacy Scale, the Social Support Rating Scale, and the Connor-Davidson Resilience Scale. Structural equation modeling with AMOS (v.24) was used to test the hypothesized model with multiple mediators. Both direct and mediational effects (through social support and self-efficacy) of medical coping modes on resilience outcomes were examined. Results: The mean Connor-Davidson Resilience Scale score was 63.78 ± 12.29. Confrontation, social support, and self-efficacy correlated with resilience (r = 0.40, 0.23, 0.72, respectively; all p < 0.01). In multiple mediation models, social support independently (effect = 0.11; 95% confidence interval [CI], 0.04-0.27) and social support and self-efficacy serially (effect = 0.06; 95% CI, 0.02-0.14) mediated the association of confrontation with resilience maintenance, accounting for 57.89 and 10.53% of the total effect, respectively. Conclusion: Social support and self-efficacy were multiple mediators of the relationship between confrontation and resilience. Interventions designed to facilitate confrontation and subsequently increase social support and self-efficacy may be useful to increase resilience in Stanford type A aortic dissection patients.
ABSTRACT
Objectives: This study aimed to develop and validate the Nurse's Workplace Mental Health Questionnaire (NWMHQ). Methods: The questionnaire was developed based on the two continua model of mental illness and health proposed by Keyes. The initial questionnaire was generated through literature review, two rounds of Delphi expert consultation, followed by a pilot survey. Finally, the reliability and validity of the questionnaire were validated through an online survey of 2,815 registered nurses selected from the public hospitals in 11 provinces from June to July 2020. Results: The item-content validity index (I-CVI) of the questionnaire ranged from 0.750 to 1.000 and the average scale-level content validity index (S-CVI/Ave) was 0.906. Cronbach's α coefficient was 0.948 and test-retest reliability was 0.850. The self-rating depression scale score was negatively related to the NWMHQ score (r = -0.664, P < 0.01). The exploratory factor analysis (EFA) yielded six factors (emotional status, psychological security, positive relationship, resilience, self-efficacy, and subjective well-being), consisting of 32 items. The cumulative variance contribution rate was 65.58%. Confirmatory factor analysis (CFA) showed an acceptable fit. Conclusion: The NWMHQ developed in this study showed good reliability and validity. This questionnaire may help assess the mental health status of nurses and help nursing managers to develop appropriate targeted psychological interventions.
