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Article(id=1324077458298909659, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077443828560770, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202509259, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1758038400000, receivedDateStr=2025-09-17, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1793614266228, onlineDateStr=2026-11-02, pubDate=1775750400000, pubDateStr=2026-04-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793614266228, onlineIssueDateStr=2026-11-02, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793614266228, creator=13701087609, updateTime=1793614266228, updator=13701087609, issue=Issue{id=1324077443828560770, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='7', pageStart='1153', pageEnd='1344', issueExtLink='null', onlineDate='null', pubDate='1775750400000', pubDateStr='2026-04-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1793614262778, creator='13701087609', updateTime=1793614352085, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1324077818509918661, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077443828560770, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1324077818509918662, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1324077443828560770, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=1159, endPage=1164, ext={EN=ArticleExt(id=1324077460106654684, articleId=1324077458298909659, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=The effect of social support on the family resilience of patients with dementia: a moderated mediation model, columnId=1240413921954295836, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the relationship between social support and family resilience in families of dementia patients, as well as its underlying mechanisms.

Methods

A questionnaire survey was conducted among 508 primary family caregivers of elderly dementia patients in Nanjing. Descriptive statistical analysis, regression analysis, and moderated mediation analysis were performed.

Results

Social support had a significant positive impact on family resilience (β=0.351, P<0.01); Family cohesion partially mediated the relationship between social support and family resilience, with a mediation effect value of 0.527 (95% CI: 0.399-0.666), accounting for 60.04% of the total effect. The second half of the mediation pathway, through which social support influences family resilience via family cohesion, was moderated by psychological resilience (β=-0.017, P<0.01).

Conclusion

This study elucidates the relationship between social support and family resilience in families of dementia patients and its underlying mechanisms, providing a theoretical foundation and practical implications for enhancing family resilience in dementia care.

, authors=Jia-yi LI, Xin-yi LIU, Li ZHANG, authorsList=Jia-yi LI, Xin-yi LIU, Li ZHANG, authorCompany=null, correspAuthors=Li ZHANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1324077461343974373, articleId=1324077458298909659, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=社会支持对痴呆患者家庭抗逆力的影响——一个有调节的中介模型, columnId=1228016567632462653, journalTitle=现代预防医学, columnName=流行病与统计方法, runingTitle=null, highlight=null, articleAbstract=
目的

本研究旨在考察社会支持与痴呆症患者家庭抗逆力的关系及其作用机制。

方法

以南京市508名老年痴呆患者的主要家庭照顾者为研究对象开展问卷调查，进行描述性统计分析、回归分析和有调节的中介效应分析。

结果

社会支持对痴呆患者家庭抗逆力具有显著正向影响（β=0.351，P<0.01）；家庭亲密度在社会支持与家庭抗逆力之间起部分中介作用，中介效应值为0.527（95%CI：0.399，0.666），占总效应的60.04%；社会支持通过家庭亲密度影响家庭抗逆力的中介作用路径后半段受到心理弹性的调节（β=-0.017，P<0.01）。

结论

本研究揭示了社会支持与老年痴呆患者家庭抗逆力的关系及其作用机制，为提升痴呆患者家庭抗逆力提供了理论依据与实践启示。

, authors=李佳翼, 刘欣怡, 张逦, authorsList=李佳翼, 刘欣怡, 张逦, authorCompany=null, correspAuthors=张逦, authorNote=

李佳翼（2002—），女，硕士在读，研究方向：社会医学与卫生事业管理

, correspAuthorsNote=
张逦，E-mail：
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Basic information of caregivers for patients with dementia

, figureFileSmall=null, figureFileBig=null, tableContent=
变量人数（%）家庭抗逆力得分（）统计量t/F值P值
性别1.6680.096
男235（46.26）101.11±15.30
女273（53.74）98.73±16.62
年龄（岁）2.9260.021
≤3913（2.56）109.31±11.75
40~4935（6.89）97.86±17.72
50~59126（24.80）100.46±15.00
60~69166（32.68）101.60±16.16
≥70168（33.07）97.28±16.23
婚姻状况2.0050.045
已婚451（88.78）100.33±15.66
未婚/离异/丧偶57（11.22）95.82±18.49
文化程度3.2450.007
文盲49（9.65）94.33±15.59
小学69（13.58）95.67±15.11
初中165（32.48）99.90±15.39
高中或职专145（28.54）102.52±15.78
大专41（8.07）102.61±19.69
本科及以上39（7.68）100.87±15.43
工作0.7800.459
在职99（19.49）101.42±15.69
无业63（12.40）98.35±14.24
退休346（68.11）99.64±16.46
与患者关系1.7960.128
配偶157（30.91）97.52±17.06
子女269（52.95）101.20±15.50
儿媳、女婿43（8.46）101.98±13.26
兄弟姐妹13（2.56）98.85±17.09
其他26（5.12）96.54±17.90
家庭月收入（元）3.9510.002
<5 000162（31.89）96.91±14.85
5 000~10 000204（40.16）100.57±15.71
10 000~15 000105（20.67）99.81±17.31
15 000~20 00025（4.92）110.96±16.47
20 000~25 0004（0.79）98.00±15.34
>25 0008（1.57）106.37±15.38
), ArticleFig(id=1324077465789935622, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077458298909659, language=CN, label=表1, caption=

痴呆患者照顾者基本情况

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变量人数（%）家庭抗逆力得分（）统计量t/F值P值
性别1.6680.096
男235（46.26）101.11±15.30
女273（53.74）98.73±16.62
年龄（岁）2.9260.021
≤3913（2.56）109.31±11.75
40~4935（6.89）97.86±17.72
50~59126（24.80）100.46±15.00
60~69166（32.68）101.60±16.16
≥70168（33.07）97.28±16.23
婚姻状况2.0050.045
已婚451（88.78）100.33±15.66
未婚/离异/丧偶57（11.22）95.82±18.49
文化程度3.2450.007
文盲49（9.65）94.33±15.59
小学69（13.58）95.67±15.11
初中165（32.48）99.90±15.39
高中或职专145（28.54）102.52±15.78
大专41（8.07）102.61±19.69
本科及以上39（7.68）100.87±15.43
工作0.7800.459
在职99（19.49）101.42±15.69
无业63（12.40）98.35±14.24
退休346（68.11）99.64±16.46
与患者关系1.7960.128
配偶157（30.91）97.52±17.06
子女269（52.95）101.20±15.50
儿媳、女婿43（8.46）101.98±13.26
兄弟姐妹13（2.56）98.85±17.09
其他26（5.12）96.54±17.90
家庭月收入（元）3.9510.002
<5 000162（31.89）96.91±14.85
5 000~10 000204（40.16）100.57±15.71
10 000~15 000105（20.67）99.81±17.31
15 000~20 00025（4.92）110.96±16.47
20 000~25 0004（0.79）98.00±15.34
>25 0008（1.57）106.37±15.38
), ArticleFig(id=1324077465890598919, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077458298909659, language=EN, label=Table 2, caption=

Descriptive statistics and correlations of each variable (r)

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变量 社会支持家庭抗逆力家庭亲密度心理弹性
社会支持33.07±7.781
家庭抗逆力99.83±16.050.436**1
家庭亲密度50.14±10.420.472**0.637**1
心理弹性27.15±8.500.271**0.329**0.266**1
), ArticleFig(id=1324077465961902088, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077458298909659, language=CN, label=表2, caption=

各变量描述统计与相关性（r）

, figureFileSmall=null, figureFileBig=null, tableContent=
变量 社会支持家庭抗逆力家庭亲密度心理弹性
社会支持33.07±7.781
家庭抗逆力99.83±16.050.436**1
家庭亲密度50.14±10.420.472**0.637**1
心理弹性27.15±8.500.271**0.329**0.266**1
), ArticleFig(id=1324077466049982473, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077458298909659, language=EN, label=Table 3, caption=

The stepwise regression results of the mediating mechanism of family cohesion

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路径回归系数t值P值
社会支持→家庭亲密度0.61511.483<0.01
社会支持→家庭抗逆力0.3514.440<0.01
家庭亲密度→家庭抗逆力0.85814.597<0.01
), ArticleFig(id=1324077466125479946, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077458298909659, language=CN, label=表3, caption=

家庭亲密度中介机制的逐步回归结果

, figureFileSmall=null, figureFileBig=null, tableContent=
路径回归系数t值P值
社会支持→家庭亲密度0.61511.483<0.01
社会支持→家庭抗逆力0.3514.440<0.01
家庭亲密度→家庭抗逆力0.85814.597<0.01
), ArticleFig(id=1324077466205171723, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077458298909659, language=EN, label=Table 4, caption=

The bootstrap test results of the mediating mechanism of family cohesion

, figureFileSmall=null, figureFileBig=null, tableContent=
效应效应值（95% CI）标准误效应占比（%）
总效应0.878（0.716~1.043）0.084
直接效应0.351（0.196~0.507）0.07939.96
间接效应0.527（0.399~0.666）0.06960.04
), ArticleFig(id=1324077466289057804, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077458298909659, language=CN, label=表4, caption=

家庭亲密度中介机制的bootstrap检验结果

, figureFileSmall=null, figureFileBig=null, tableContent=
效应效应值（95% CI）标准误效应占比（%）
总效应0.878（0.716~1.043）0.084
直接效应0.351（0.196~0.507）0.07939.96
间接效应0.527（0.399~0.666）0.06960.04
), ArticleFig(id=1324077466372943885, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077458298909659, language=EN, label=Table 5, caption=

Test of moderated mediating effect

, figureFileSmall=null, figureFileBig=null, tableContent=
变量方程1：家庭抗逆力方程2：家庭亲密度方程3：家庭抗逆力
βtβtβt
社会支持0.3514.440**0.61511.483**0.2943.764**
家庭亲密度0.79813.680**
心理弹性0.2764.239**
家庭亲密度×心理弹性-0.017-2.961**
R0.6660.4850.689
R20.4440.2350.474
F49.728**21.957**44.804**
), ArticleFig(id=1324077466465218574, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1324077458298909659, language=CN, label=表5, caption=

有调节的中介效应检验

, figureFileSmall=null, figureFileBig=null, tableContent=
变量方程1：家庭抗逆力方程2：家庭亲密度方程3：家庭抗逆力
βtβtβt
社会支持0.3514.440**0.61511.483**0.2943.764**
家庭亲密度0.79813.680**
心理弹性0.2764.239**
家庭亲密度×心理弹性-0.017-2.961**
R0.6660.4850.689
R20.4440.2350.474
F49.728**21.957**44.804**
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社会支持对痴呆患者家庭抗逆力的影响——一个有调节的中介模型
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李佳翼 , 刘欣怡 , 张逦
现代预防医学 | 流行病与统计方法 2026,53(7): 1159-1164
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现代预防医学 |流行病与统计方法 2026 , 53 (7) : 1159 -1164
社会支持对痴呆患者家庭抗逆力的影响——一个有调节的中介模型
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李佳翼（2002—），女，硕士在读，研究方向：社会医学与卫生事业管理

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李佳翼, 刘欣怡, 张逦
作者信息
  • 南京中医药大学卫生经济管理学院，江苏　南京　210023
通讯作者:
张逦，E-mail：
作者简介:

李佳翼（2002—），女，硕士在读，研究方向：社会医学与卫生事业管理

The effect of social support on the family resilience of patients with dementia: a moderated mediation model
Jia-yi LI, Xin-yi LIU, Li ZHANG
Affiliations
  • School of Health Economics and Management, Nanjing University of Traditional Chinese Medicine, Nanjing, Jiangsu 210023, China
出版时间: 2026-04-10 doi: 10.20043/j.cnki.MPM.202509259
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摘要
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目的

本研究旨在考察社会支持与痴呆症患者家庭抗逆力的关系及其作用机制。

方法

以南京市508名老年痴呆患者的主要家庭照顾者为研究对象开展问卷调查，进行描述性统计分析、回归分析和有调节的中介效应分析。

结果

社会支持对痴呆患者家庭抗逆力具有显著正向影响（β=0.351，P<0.01）；家庭亲密度在社会支持与家庭抗逆力之间起部分中介作用，中介效应值为0.527（95%CI：0.399，0.666），占总效应的60.04%；社会支持通过家庭亲密度影响家庭抗逆力的中介作用路径后半段受到心理弹性的调节（β=-0.017，P<0.01）。

结论

本研究揭示了社会支持与老年痴呆患者家庭抗逆力的关系及其作用机制，为提升痴呆患者家庭抗逆力提供了理论依据与实践启示。

痴呆  /  社会支持  /  家庭亲密度  /  心理弹性  /  家庭抗逆力
Objective

To explore the relationship between social support and family resilience in families of dementia patients, as well as its underlying mechanisms.

Methods

A questionnaire survey was conducted among 508 primary family caregivers of elderly dementia patients in Nanjing. Descriptive statistical analysis, regression analysis, and moderated mediation analysis were performed.

Results

Social support had a significant positive impact on family resilience (β=0.351, P<0.01); Family cohesion partially mediated the relationship between social support and family resilience, with a mediation effect value of 0.527 (95% CI: 0.399-0.666), accounting for 60.04% of the total effect. The second half of the mediation pathway, through which social support influences family resilience via family cohesion, was moderated by psychological resilience (β=-0.017, P<0.01).

Conclusion

This study elucidates the relationship between social support and family resilience in families of dementia patients and its underlying mechanisms, providing a theoretical foundation and practical implications for enhancing family resilience in dementia care.

Dementia  /  Social support  /  Family cohesion  /  Psychological resilience  /  Family resilience
李佳翼, 刘欣怡, 张逦. 社会支持对痴呆患者家庭抗逆力的影响——一个有调节的中介模型. 现代预防医学, 2026 , 53 (7) : 1159 -1164 . DOI: 10.20043/j.cnki.MPM.202509259
Jia-yi LI, Xin-yi LIU, Li ZHANG. The effect of social support on the family resilience of patients with dementia: a moderated mediation model[J]. Modern Preventive Medicine, 2026 , 53 (7) : 1159 -1164 . DOI: 10.20043/j.cnki.MPM.202509259
正文
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老年痴呆是一种以进行性认知功能减退为核心特征的不可逆的神经系统退行性疾病，疾病进展后会出现躯体功能下降、生活不能自理[1]，需依赖他人照护，是中国老年人残疾和死亡的主要原因之一[2]。目前，中国现有痴呆患者约1 700万，且逐年呈上升趋势[3]。老年痴呆目前尚无根治手段，目前仅能通过药物延缓病情进展，但无法逆转神经性损伤[4]。中国痴呆症患者日常照护主要依赖家庭照顾者[5]。痴呆患者的照护过程漫长且艰巨，多数家庭面临着照护知识缺乏、经济负担沉重、情感压力巨大等多重困境，导致家庭系统容易陷入脆弱状态，难以有效应对疾病带来的持续冲击[6]。
在本研究中，社会支持是指痴呆患者家庭在社会网络中所获得的能够提供的物质帮助和精神价值的社会资源；家庭抗逆力是指家庭作为一个整体，在面对共同困难或挑战时所展现出来的适应和恢复能力[7]。社会支持作为家庭外部重要的资源补充，能够为痴呆患者家庭提供必要的帮助，缓解其照护压力，增强家庭应对危机的信心[8]。既往研究[9]显示，充足的社会支持能够显著提升家庭抗逆力水平。基于此，本研究提出假设。H1：社会支持对痴呆患者家庭抗逆力有直接的正向影响。家庭亲密度是指家庭成员间相互承诺、帮助和支持的程度[10]；社会支持通过增强个体的自我效能感和归属感，间接促进家庭成员间的积极互动。主观社会支持水平高的个体更易主动表达情感，进而促进家庭亲密度提升[11]。既往研究[12]表明，家庭亲密度对家庭抗逆力存在显著正向作用：当家庭成员间情感紧密、沟通顺畅、协作良好，面对压力或困境更易形成统一应对策略，降低内耗。基于此，本研究提出假设。H2：社会支持通过中间变量家庭亲密度作用于家庭抗逆力。心理弹性也称心理韧性，是个体在面临创伤、逆境这类严重应激事件时，所具备的一种能迅速复原、有效应对且保持良好心理状态的能力[13]。作为一种内在心理资源，心理弹性不仅有助于个体在危机中维持功能，也可能增强家庭系统在应对长期照护压力时的适应能力[14]。具体而言，家庭亲密度通过成员间的情感联结与支持行为促进家庭抗逆力，而心理弹性则可调节这一过程。高心理弹性的家庭更能够将亲密度转化为有效的应对策略，在面对痴呆照护压力时保持家庭功能的完整性与适应性；因此，心理弹性可能是影响家庭亲密度与家庭抗逆力间的调节变量。基于此，本研究提出假设。H3：心理弹性在家庭亲密度与家庭抗逆力中起调节作用。
当前，尚未有研究探讨社会支持与痴呆患者家庭抗逆力的直接关联及内在作用机制。综上所述，本研究将探讨社会支持对痴呆患者家庭抗逆力的影响及家庭亲密度与心理弹性的作用（假设模型见图1），以期揭示社会支持如何以及在何种情况下影响痴呆患者的家庭抗逆力，助力完善照护支持体系、改善患者及照顾者生活质量。
1　对象与方法
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1.1　研究对象
本研究于2024年采用便利抽样法，选取南京市514名老年痴呆患者的主要照顾者为研究对象，痴呆患者的纳入标准：（1）经医生明确诊断的60岁以上痴呆患者，痴呆类型包括阿尔茨海默病、血管性痴呆或混合型痴呆；（2）确诊后在家居住时间≥6个月；排除标准：患者的确诊时间≤6个月。家庭照顾者纳入标准：（1）照顾者年龄为18周岁及以上；（2）为承担患者日常主要照顾责任的家庭成员；（3）对于本次研究知情同意；排除标准：（1）照顾者与患者为雇佣关系或无亲属关系；（2）照顾者存在交流或认知障碍。南京医科大学伦理委员会审核批准本项研究，批件号为南医大伦审（2024）812号。
1.2　调查内容
（1）社会人口学特征：性别、年龄、婚姻状况、文化程度、与患者关系、家庭月收入、照顾时长等。
（2）社会支持　采用肖水源[15]编制的社会支持评定量表。该量表总分为12~66分，量表评分与社会支持水平呈正相关，得分越高，社会支持水平越佳。在本次研究中，该量表的Cronbach α系数为0.896。
（3）家庭亲密度　本研究采用费立鹏等[16]修订的家庭亲密度与适应性量表亲密度分量表。该量表总分为16~80分，量表得分与家庭亲密度呈正相关，即分数越高，家庭亲密度越佳。经检验，该量表的Cronbach α系数为0.851。
（4）家庭抗逆力　本研究采用李玉丽等[17]汉化编制的家庭抗逆力评定量表简版。该量表总分为32~128分，得分越高，表明受试者家庭抗逆力水平越高。在本次研究中，该量表的Cronbach α系数达到0.954。
（5）心理弹性　本研究基于Connor和Davidson[18]编制的心理弹性量表（Connor-Davidson resilience scale，CD-RISC）开发的正式简化中文版，该量表[19]总分为0~40分。量表总分越高，代表个体心理弹性水平越高。本研究中量表的Cronbach α系数为0.941。
1.3　控制变量
本研究选择患者痴呆严重程度、患者日常生活活动能力、照顾者照顾时长（年数）、家庭月收入、照顾者年龄、照顾者与患者关系类型为控制变量。
1.4　资料收集方法
在确保符合纳入/排除标准的前提下，本研究通过痴呆照护机构（心贴心、银城康养等）提供的家庭名单，结合痴呆患者家庭互助群与受访家属推荐，共发放问卷514份，回收有效问卷508份，有效率98.83%。调研采用一对一入户面对面访谈，调查员为经过统一培训的研究生，在获得知情同意并由机构护理员陪同下逐题朗读纸质问卷、记录答复，现场核对并修正遗漏与错误，收回后对问卷进行双人双录并进行一致性检验，以确保数据质量。
1.5　统计学方法
采用SPSS 26.0软件对本研究数据进行统计分析，使用PROCESS插件进行有调节的中介效应分析。检验水准α=0.05。
1.6　共同方法偏差的控制与检验
本研究运用Harman单因子检验法，借助SPSS 26.0对所有题项进行探索性因素分析。结果显示，特征根大于1的因素共计18个，首个因素解释的累积变异量为27.80%，未超过40%，表明本研究数据不存在严重的共同方法偏差。
2　结果
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2.1　痴呆患者照顾者基本情况
本研究共纳入痴呆患者照顾者508人，其中男性235人，女性273人。见表1。
2.2　描述性统计和相关分析
经检验，本研究样本近似服从正态分布，采用Pearson相关分析，分析结果见表2。痴呆患者照顾者的社会支持水平分别与家庭抗逆力、家庭亲密度和心理弹性呈显著正相关（P<0.01），家庭抗逆力分别与家庭亲密度和心理弹性呈显著正相关（P<0.01），家庭亲密度与心理弹性呈显著正相关（P<0.01）。
2.3　社会支持、家庭抗逆力及家庭亲密度的中介效应分析
本文使用逐步回归法检验家庭亲密度的中介机制，结果见表3。首先以家庭亲密度为被解释变量，以社会支持为自变量，加入控制变量建立回归模型，得到的结果为社会支持对家庭亲密度具有显著的正向影响（P<0.01）。然后以家庭抗逆力为被解释变量，以社会支持、家庭亲密度同时作为自变量，并加入控制变量建立回归模型，得到社会支持和家庭亲密度均对家庭抗逆力具有显著的正向影响（P<0.01）。
偏差校正的bootstrap检验进一步表明，家庭亲密度水平的中介效应显著，间接效应值为0.527，置信区间不包含0，中介效应占总效应的比例为60.04%。假设H1、H2均成立。Bootstrap检验结果见表4。
2.4　社会支持与家庭抗逆力：有调节的中介模型检验
本研究采用Hayes编制的SPSS宏程序Model 14检验心理弹性的调节作用，结果见表5。方程1　检验社会支持对家庭抗逆力的直接效应；方程2　检验社会支持对家庭亲密度的预测作用；方程3　将心理弹性纳入回归方程模型，家庭亲密度与心理弹性的交互项对痴呆患者家庭抗逆力的影响作用显著。说明心理弹性调节社会支持通过家庭亲密度的中介作用影响痴呆患者家庭抗逆力的后半段路径（β=-0.017，t=-2.961，P<0.01，95%CI：-0.028，-0.006）。综上所述，3个假设均成立。
为了更清晰地揭示调节效应的实质，我们将心理弹性按平均数加减一个标准差分为高分组和低分组进行简单斜率分析，并绘制了简单斜率分析图，见图2。结果表明，对于低心理弹性的痴呆患者家庭，家庭亲密度对家庭抗逆力有显著的正向影响作用（simple slope=0.940，t=13.149，P<0.01）；而对于高心理弹性的痴呆患者家庭，家庭亲密度对家庭抗逆力仍存在显著的正向影响作用（simple slope=0.656，t=8.283，P<0.01），但正向影响作用相较于低心理弹性家庭明显减弱（simple slope从0.940降低至0.656）。该结果表明：家庭亲密度对家庭抗逆力的影响，会随个体心理弹性水平的提升而减弱，即对于不同心理弹性水平的痴呆家庭而言，社会支持通过家庭亲密度的中介对家庭抗逆力的影响效应不同。
3　讨论
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3.1　家庭亲密度在痴呆患者社会支持与家庭抗逆力之间起中介作用
本研究发现，家庭亲密度在社会支持与家庭抗逆力之间起部分中介作用，中介效应占比约为60.04%。这一结果表明，社会支持通过强化家庭应对困境的能力，进而提升家庭亲密度，这种家庭亲密度能够优化家庭内部协作模式，降低家庭的照护压力感知，从而间接提高家庭抗逆力。基于此，提升家庭获得的社会支持质量与家庭亲密度是增强家庭抗逆力的关键路径。然而，现实中社会支持的形式、内容与传递常存在模糊性，导致家庭难以理解、整合和利用外部资源，进而削弱支持对抗逆力的促进作用[20]。为此，建议社区、医疗与公益机构构建以家庭为中心且易于理解的支持体系[21]，鼓励家庭参与支持方案设计，明确支持内容与获取途径，并建立可追溯的评价与反馈机制，以提高支持的可用性、可信度与实际效用，从而更有效地促进家庭亲密度与家庭抗逆力的提升。
3.2　心理弹性在“社会支持-家庭亲密度-家庭抗逆力”中介模型的后半段起调节作用
本研究证实，心理弹性在中介路径后半段具有显著调节作用。具体而言，当照顾者心理弹性水平较低时，家庭亲密度对家庭抗逆力的正向影响作用更为突出；而随着照顾者心理弹性水平提升，家庭亲密度对家庭抗逆力的正向影响作用呈大幅度减弱趋势。
从理论视角分析，该结果契合“心理资源互补”的作用逻辑：心理弹性作为个体应对逆境的核心心理资源，与家庭亲密度存在资源代偿关系[22]。对于心理弹性水平偏低的照顾者，其逆境复原与压力调节能力有限，此时家庭亲密度承载的情感支持成为应对痴呆照护压力的核心资源载体，因此对家庭抗逆力的增益效应更为凸显；而当照顾者心理弹性较高时，个体已具备较强的逆境应对能力，对家庭情感支持的依赖程度降低，家庭亲密度的作用因此被部分稀释，但仍可通过优化家庭内部互动模式间接促进抗逆力，故正向影响作用仍保持显著。
从实践角度看，本研究提示应依据照顾者的心理弹性水平开展分层干预。对于低心理弹性家庭，干预可优先着眼于提升家庭亲密度，例如通过家庭治疗[23]、沟通培训[24]等方式强化成员间的情感联结与协作，充分发挥家庭亲密度在资源匮乏情境下的主要支持作用；对于高心理弹性家庭，则可侧重于促进个体心理资源向家庭系统的转化，例如通过团体辅导[25]引导照顾者将自身的积极认知与压力调节策略传递至家庭内部，实现个体与家庭资源的协同。同时，应始终重视心理弹性培育与家庭亲密度提升的双向促进，通过正念训练、压力管理课程与家庭互动优化措施并进，构建“个体-家庭”资源的良性循环，从而全面提升家庭应对照护挑战的潜能，使家庭亲密度在个体资源相对不足时发挥核心支持作用。
本研究也存在一定局限性有待后续研究完善。一是，采用横断面设计，变量间因果关系论证强度有限，仍需纵向设计的研究进行验证。二是，样本仅聚焦于南京市，且由于现实因素入户困难，可能更集中于配合意愿较高的家庭，代表性有限，未来可扩展多地域样本数据。
基金
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  • 国家自然科学基金资助项目(72004103)
  • 江苏省研究生科研与实践创新计划项目(KYCX25_2440; KYCX24_2122)
文献
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2026年第53卷第7期
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doi: 10.20043/j.cnki.MPM.202509259
  • 接收时间：2025-09-17
  • 首发时间：2026-11-02
  • 出版时间：2026-04-10
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  • 收稿日期：2025-09-17
基金
国家自然科学基金资助项目(72004103)
江苏省研究生科研与实践创新计划项目(KYCX25_2440; KYCX24_2122)
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    南京中医药大学卫生经济管理学院，江苏　南京　210023

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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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