目的 探讨应对方式在手部烧伤患者烧伤结局与伤残接受度之间的中介效应。 方法 采用方便抽样法选择苏州市某三甲医院2021年4月至2022年6月收治的156例手部烧伤患者为调查对象，采用医学应对方式问卷、伤残接受度量表、中文版手部烧伤结局评估工具对其进行评分。 结果 （1）3种应对方式与伤残接受度的相关性：面对（r=0.661）呈正相关，回避（r=-0.442）呈负相关，屈服（r=-0.621）呈负相关（均P＜0.01）。（2）结构方程模型显示3种应对方式对伤残接受度的预测：面对为直接正向预测（β=0.072）、回避与屈服为直接负向预测（β=-0.081、β=-0.115）（均P＜0.01）；手部烧伤结局通过应对方式对伤残接受度发挥间接效应（总中介效应=0.046，直接效应=0.160，总效应=0.206，中介效应占比22.33%，P＜0.05）。 结论 手部烧伤结局可通过应对方式影响患者的伤残接受度，其中面对起正向作用，屈服、回避均起负向作用；建议采用多种干预措施减少患者有关屈服及回避的负向应对，提高其对手部伤残的接受度。

Objective To explore the mediating effect of coping styles between burn outcomes and acceptance of disability among patients with burnt hands. Methods Convenient sampling was used to select 156 patients with burnt hands from a tertiary hospital in Suzhou City from April,2021 to June,2022.The Medical Coping Modes Questionnaire,Acceptance of Disability Scale,and Chinese Version-Burnt Hand Outcome Tool were used for scoring. Results Acceptance of disability was positively correlated with confrontation (r=0.661),and negatively correlated with avoidance (r=-0.442) and yielding (r=-0.621) (all P＜0.01).Structural equation model showed that confrontation directly and positively predicted acceptance of disability (β=0.072),avoidance and yielding directly and negatively predicted acceptance of disability (β=-0.081,β=-0.115) (all P＜0.01).The burnt hand outcome exerted an indirect effect on acceptance of disability through coping styles (total mediating effect=0.046,direct effect=0.160,total effect=0.206,mediating effect accounting for 22.33% of total effect,P＜0.05). Conclusions The burnt hand outcome can affect the patients’ acceptance of disability through coping styles,in which confrontation plays a positive role,and yielding and avoidance play negative roles.It is suggested to adopt various intervention measures to reduce negative coping styles of yielding and avoidance,so as to improve their acceptance of hand disability.

R49

苏州大学附属张家港医院临床科研项目“攀登者”计划（ZJGSYY004）