来源：风湿病与关节炎,2024,13（6）:5-10.

自我感受负担在类风湿关节炎患者病耻感和生活质量之间的中介效应

谢莎莎¹，石国凤¹，曾　苹²，卜梦兰¹，肖杨杨¹，梁远俊¹，陈宗梅¹

　　【摘　要】目的：探讨自我感受负担在类风湿关节炎患者病耻感与生活质量之间的中介效应。方法：采用便利抽样法，选取2023年6月至2023年8月在贵州中医药大学第二附属医院风湿免疫科就诊的211例类风湿关节炎患者为研究对象，使用一般资料表、慢性病耻感量表、自我感受负担量表、类风湿关节炎生活质量量表进行调查。结果：类风湿关节炎患者病耻感总分为（71.24±11.84）分，自我感受负担总分为（33.41±4.29）分，生活质量总分为（69.64±12.35）分。病耻感与生活质量呈负相关（r = 0.617，P < 0.001），自我感受负担与生活质量呈负相关（r = -0.568，P < 0.001）。病耻感对生活质量的总效应为-0.595（95%CI = ［-0.698，-0.492］，P < 0.001），直接效应为-0.436（95%CI = ［-0.603，-0.268］，P < 0.001），间接效应为-0.160（95%CI = ［-0.308，-0.036］，P < 0.05），中介效应占比为26.84%。结论：类风湿关节炎患者病耻感、自我感受负担水平较高，生活质量水平较低，病耻感与自我感受负担均是生活质量水平的负向预测因子。病耻感通过自我感受负担间接影响生活质量，提示医务人员应采取有效措施，及时降低类风湿关节炎患者病耻感、自我感受负担水平，进而达到改善生活质量的目标。

　　【关键词】　类风湿关节炎；病耻感；自我感受负担；生活质量；中介效应

The Mediating Effect of Self-perceived Burden on the Relationship Between Stigma and Quality of Life in Patients with Rheumatoid Arthritis

XIE Sha-sha,SHI Guo-feng,ZENG Ping,BU Meng-lan,XIAO Yang-yang,LIANG Yuan-jun,CHEN Zong-mei

　　【ABSTRACT】Objective:To explore the mediating effect of self-perceived burden on the relationship between stigma and quality of life in patients with rheumatoid arthritis（RA）.Methods:Convenience sampling was used to select 211 patients with RA who visited the Rheumatology and Immunology Department of the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from June 2023 to August 2023 as the research subjects.A survey was conducted using the General Information Scale,Chronic Disease Stigma Scale,Self-Perceived Burden Scale,and Scale of RA Patients' Quality of Life.Results:The total score of stigma in RA patients was（71.24±11.84）,the total score of self-perceived burden was（33.41±4.29）,and the total score of quality of life was（69.64±12.35）.Disease stigma is negatively correlated with quality of life（r = 0.617,P < 0.001）,while self-perceived burden is negatively correlated with quality of life（r = -0.568,P < 0.001）.The total effect of disease stigma on quality of life is -0.595（95%CI = ［-0.698,-0.492］,P < 0.001）,the direct effect is -0.436（95%CI = ［-0.603,-0.268］,P < 0.001）,the indirect effect is -0.160（95%CI = ［-0.308,-0.036］，P < 0.05）,and the mediating effect accounts for 26.84%.Conclusion:RA patients have higher levels of stigma and self-perceived burden,but lower quality of life.Both stigma and self-perceived burden are negative predictors of quality of life.The sense of stigma indirectly affects the quality of life through self-perceived burden,which suggests that medical personnel should take effective measures to timely reduce the level of stigma and self-perceived burden in RA patients,in order to achieve the goal of improving their quality of life.

　　【Keywords】 rheumatoid arthritis;disease stigma;self-perceived burden;quality of life;mediating effect