目的 基于主客体互倚模型分析脑卒中患者及其配偶照顾者家庭韧性对心理困扰的影响。方法 便利抽取河南省4所三级甲等医院住院脑卒中患者及其配偶照顾者381对为研究对象，采用一般资料调查表、改良Rankin量表、中文版家庭韧性问卷和凯斯勒心理困扰量表对其进行调查，建立家庭韧性对心理困扰的主客体互倚模型。结果 脑卒中患者心理困扰发生率为58.30%，高于配偶照顾者心理困扰发生率48.60%（P＜0.05）。患者夫妻双方的家庭韧性、心理困扰均呈正相关（均P＜0.01），其自身家庭韧性与对方心理困扰呈负相关（均P＜0.01）。主体效应方面，脑卒中患者夫妻家庭韧性均可影响自身心理困扰（均P＜0.01）；客体效应方面，二者家庭韧性均可影响对方的心理困扰（均P＜0.05）。结论 脑卒中患者及其配偶照顾者家庭韧性与双方心理困扰存在交互影响，应将二者视为整体从家庭韧性入手进行干预，降低双方的心理困扰。

Objective To explore the influence of family resilience on psychological distress of stroke patients and their spousal caregivers based on the Actor-Partner Interdependence Model(APIM).Methods The convenience sampling method was used to select 381 pairs of stroke patients and their spousal caregivers from four tertiary A hospitals in Henan Province,China.The general information questionnaire,the modified Rankin Scale,the Chinese version of the Family Resilience Questionnaire,and the Kessler Psychological Distress Scale were used for data collection.The effects of family resilience on psychological distress in stroke patients and their spousal caregivers were analyzed with APIM.Results The incidence of psychological distress in stroke patients was 58.30%, higher than that in spousal caregivers, 48.60% (P＜0.05).The family resilience and psychological distress of patients were positively correlated with those of their spousal caregivers (P＜0.01).The family resilience of the spousal caregivers was negatively correlated with patients’ psychological distress(P＜0.01).Regarding the actors’ effects, the family resilience of both stroke patients and spousal caregivers had a significant impact on their own psychological distress (P＜0.01).Regarding the partners’ effects,the family resilience of both parties had a significant impact on the psychological distress of the other party (P＜0.05).Conclusions The family resilience of stroke patients and their spousal caregivers interacts with their psychological distress,and the two should be considered as a whole to first intervene in their family resilience to reduce their psychological distress.

R473.54

国家自然科学基金资助项目（72004205）；河南省高校科技创新团队（22IRTSTHN027）