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Article(id=1241034442542739751, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241034441380917539, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202411041, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1730649600000, receivedDateStr=2024-11-04, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773815268407, onlineDateStr=2026-03-18, pubDate=1749484800000, pubDateStr=2025-06-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773815268407, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773815268407, creator=13701087609, updateTime=1773815268407, updator=13701087609, issue=Issue{id=1241034441380917539, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='11', pageStart='1921', pageEnd='2112', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773815268130, creator=13701087609, updateTime=1773815340947, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241034746873049765, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241034441380917539, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241034746873049766, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241034441380917539, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1928, endPage=1934, ext={EN=ArticleExt(id=1241034442836341038, articleId=1241034442542739751, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Analysis of the perceived stress status and influencing factors among elderly HIV-infected individuals/AIDS patients, columnId=1240413921954295836, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the current status of perceived HIV/AIDS-related stress among elderly individuals living with HIV/AIDS (PLWHA) and its influencing factors, and to explore the mediating role of psychological resilience between social support and HIV/AIDS-related stress.

Methods

A convenience sampling method was employed to include 405 elderly PLWHA from the Infectious Diseases and Immunology Department of Changsha Infectious Disease Hospital between January and February 2024. The on-site questionnaire included the Social Support Rating Scale (SSRS), the 10-item Connor-Davidson Resilience Scale (CD-RISC-10), the Chinese HIV/AIDS Stress Scale (CSS-HIV), as well as demographic and disease characteristic information. Descriptive analysis, univariate analysis, and multiple stepwise linear regression were used to analyze the current status and influencing factors of HIV/AIDS-related stress; mediation analysis was conducted to explore the mediating effect of psychological resilience on HIV/AIDS-related stress.

Results

The total score for HIV/AIDS-related stress among elderly PLWHA was 24.84±14.01, with emotional stress scoring 5.91±5.98,social stress 14.23±6.21, and instrumental stress 4.71±4.74. Factors influencing HIV/AIDS-related stress included being retired or engaged in farming, comorbidities, levels of social support, and psychological resilience (P<0.05). Psychological resilience showed a partial mediating effect in the relationship between social support and HIV/AIDS-related stress, accounting for 40.81% of the mediation effect.

Conclusion

Psychological resilience partially mediates the impact of social support on HIV/AIDS-related stress among elderly PLWHA. Interventions aimed at improving the status of social support and enhancing the psychological resilience of patients may help alleviate HIV/AIDS-related stress, thereby reducing their psychological burden and suffering.

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目的

分析老年HIV感染者/AIDS患者（people living with HIV/AIDS，PLWHA）感知艾滋病相关压力的现状及其影响因素，探讨心理韧性在社会支持和艾滋病相关压力之间的中介作用。

方法

于2024年1—2月采用方便抽样法，纳入长沙市传染病医院感染与免疫科门诊405名老年PLWHA为研究对象。现场问卷调查内容包括社会支持评定量表（social support rating scale，SSRS）、简版心理韧性量表（10-item connor-davidson resilience scale，CD-RISC-10）、艾滋病相关压力量表（Chinese HIV/AIDS stress scale，CSS-HIV）以及社会人口学与疾病特征信息。通过描述性分析、单因素分析和多元逐步线性回归分析艾滋病相关压力现状及其影响因素；通过中介效应分析探索心理韧性对艾滋病相关压力的中介作用。

结果

老年PLWHA的艾滋病相关压力总分为（24.84±14.01）分，其中情绪压力为（5.91±5.98）分、社会压力为（14.23±6.21）分、工具性压力为（4.71±4.74）分。离/退休或务农、患有共病、社会支持和心理韧性水平是艾滋病相关压力的影响因素（P<0.05）。心理韧性在社会支持与艾滋病相关压力的关系中存在部分中介效应，中介效应占比为40.81%。

结论

老年PLWHA的心理韧性对艾滋病相关压力发挥部分中介影响。以改善社会支持现状，提升患者心理韧性水平为目标展开干预研究，将有助于缓解艾滋病相关压力，减轻其心理负担和痛苦。

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王红妹与谢建平为共同通信作者。王红妹，E-mail:；
谢建平，E-mail:；
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=FePfxyjz8LO1wRiigdri5w==, magXml=CkUjBmi7nudYuiK9ksU9oQ==, pdfUrl=null, pdf=LN0bLCYRuzlOTTwjFvSdTQ==, pdfFileSize=703083, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=1GsV7zCQ/zxOvFI9HLnTEg==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=hEtAqUOggvmnMPmy0pFI1Q==, mapNumber=null, authorCompany=null, fund=null, authors=

许鑫慧与曹桂英为共同第一作者

许鑫慧（2000—），女，硕士在读，研究方向：社会医学与卫生事业管理；

曹桂英（1987—），女，硕士，主管护师，研究方向：艾滋病的护理及管理；

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许鑫慧（2000—），女，硕士在读，研究方向：社会医学与卫生事业管理；

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许鑫慧（2000—），女，硕士在读，研究方向：社会医学与卫生事业管理；

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曹桂英（1987—），女，硕士，主管护师，研究方向：艾滋病的护理及管理；

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曹桂英（1987—），女，硕士，主管护师，研究方向：艾滋病的护理及管理；

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Community follow-up management-based social support for HIV/AIDS patients aged 50 and above in Luzhou City[J]. Chinese Journal of AIDS & STD, 2024, 30(1): 39-43.(In Chinese), articleTitle=Community follow-up management-based social support for HIV/AIDS patients aged 50 and above in Luzhou City, refAbstract=null), Reference(id=1241050847170326743, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442542739751, doi=null, pmid=null, pmcid=null, year=2022, volume=36, issue=9, pageStart=1665, pageEnd=1670, url=null, language=null, rfNumber=[19], rfOrder=26, authorNames=吉俊霞, 姚翠, journalName=护理研究, refType=null, unstructuredReference=吉俊霞， 姚翠.永久性结肠造口病人心理韧性在自我护理能力与希望水平间的中介效应[J].护理研究，2022，36（9）：1665-1670., articleTitle=永久性结肠造口病人心理韧性在自我护理能力与希望水平间的中介效应, refAbstract=null), Reference(id=1241050847405207771, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442542739751, doi=null, pmid=null, pmcid=null, year=2022, volume=36, issue=9, pageStart=1665, pageEnd=1670, url=null, language=null, rfNumber=[19], rfOrder=27, authorNames=Ji JX, Yao C, journalName=Chinese Nursing Research, refType=null, unstructuredReference=Ji JX, Yao C. Mediating effect of mental toughness between self?care ability and hope level of patients with permanent colostomy[J]. Chinese Nursing Research, 2022, 36(9): 1665-1670.(In Chinese), articleTitle=Mediating effect of mental toughness between self?care ability and hope level of patients with permanent colostomy, refAbstract=null), Reference(id=1241050847921107168, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442542739751, doi=null, pmid=null, pmcid=null, year=2021, volume=21, issue=1, pageStart=1413, pageEnd=null, url=null, language=null, rfNumber=[20], rfOrder=28, authorNames=Li Y, Zhang XW, Liao B, journalName=BMC Public Health, refType=null, unstructuredReference=Li Y, Zhang XW, Liao B, et al. Social support status and associated factors among People living with HIV/AIDS in Kunming city, China[J]. BMC Public Health, 2021, 21(1): 1413., articleTitle=Social support status and associated factors among People living with HIV/AIDS in Kunming city, China, refAbstract=null), Reference(id=1241050848336343268, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442542739751, doi=null, pmid=null, pmcid=null, year=2022, volume=22, issue=1, pageStart=557, pageEnd=566, url=null, language=null, rfNumber=[21], rfOrder=29, authorNames=Desta F, Tasew A, Tekalegn Y, journalName=BMC Psychiatry, refType=null, unstructuredReference=Desta F, Tasew A, Tekalegn Y, et al. Prevalence of depression and associated factors among People living with HIV/AIDS in public hospitals of Southeast Ethiopia[J]. BMC Psychiatry, 2022, 22(1): 557-566., articleTitle=Prevalence of depression and associated factors among People living with HIV/AIDS in public hospitals of Southeast Ethiopia, refAbstract=null), Reference(id=1241050848625750249, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442542739751, doi=null, pmid=null, pmcid=null, year=2022, volume=28, issue=10, pageStart=1222, pageEnd=1225, url=null, language=null, rfNumber=[22], rfOrder=30, authorNames=郝晓宇, 杨志敏, 霍俊丽, journalName=中国艾滋病性病, refType=null, unstructuredReference=郝晓宇，杨志敏，霍俊丽，等.HIV感染者生命质量研究进展[J].中国艾滋病性病，2022，28（10）：1222-1225., articleTitle=HIV感染者生命质量研究进展, refAbstract=null), Reference(id=1241050848713830635, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442542739751, doi=null, pmid=null, pmcid=null, year=2022, volume=28, issue=10, pageStart=1222, pageEnd=1225, url=null, language=null, rfNumber=[22], rfOrder=31, authorNames=Hao XY, Yang ZM, Huo JL, journalName=Chinese Journal of AIDS & STD, refType=null, unstructuredReference=Hao XY, Yang ZM, Huo JL, et al. Research progress on quality of Life of People living with HIV[J]. Chinese Journal of AIDS & STD, 2022, 28(10):1222-1225.(In Chinese), articleTitle=Research progress on quality of Life of People living with HIV, refAbstract=null), Reference(id=1241050848814493935, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442542739751, doi=null, pmid=null, pmcid=null, year=2019, volume=11, issue=1, pageStart=2071, pageEnd=2076, url=null, language=null, rfNumber=[23], rfOrder=32, authorNames=Adamu A, Mchunu G, Naidoo JR, journalName=Afr J Prim Health Care Fam Med, refType=null, unstructuredReference=Adamu A, Mchunu G, Naidoo JR.Stress and resilience among women living with HIV in Nigeria[J]. Afr J Prim Health Care Fam Med, 2019, 11(1): 2071-2076., articleTitle=Stress and resilience among women living with HIV in Nigeria, refAbstract=null), Reference(id=1241050849087123696, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442542739751, doi=null, pmid=null, pmcid=null, year=2023, volume=34, issue=6, pageStart=502, pageEnd=526, url=null, language=null, rfNumber=[24], rfOrder=33, authorNames=Haase SR, Billings R, Vance DE, journalName=The Journal of the Association of Nurses in AIDS Care, refType=null, unstructuredReference=Haase SR, Billings R, Vance DE, et al. The association between intrapersonal resilience resources and quality of Life among older persons living with HIV:A systematic review[J]. The Journal of the Association of Nurses in AIDS Care, 2023, 34(6): 502-526., articleTitle=The association between intrapersonal resilience resources and quality of Life among older persons living with HIV:A systematic review, refAbstract=null)], funds=[Fund(id=1241050842195882033, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442542739751, awardId=72174177, language=CN, fundingSource=国家自然科学基金(72174177), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241050831240360464, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442542739751, xref=1., ext=[AuthorCompanyExt(id=1241050831252943378, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442542739751, companyId=1241050831240360464, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Department of Social Medicine, School of Public Health, Zhejiang University, Hangzhou, Zhejiang 310058, China), AuthorCompanyExt(id=1241050831261331989, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442542739751, companyId=1241050831240360464, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.浙江大学公共卫生学院社会医学系，浙江 杭州 310058)]), AuthorCompany(id=1241050831424909850, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442542739751, xref=2., ext=[AuthorCompanyExt(id=1241050831433298462, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442542739751, companyId=1241050831424909850, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.长沙市第一医院感染与免疫科，湖南 长沙 410001)])], figs=[ArticleFig(id=1241050840216171478, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442542739751, language=EN, label=Figure 1, caption=The mediating effect model diagram of resilience between social support and HIV/AIDS-related stress in elderly PLWHA, figureFileSmall=jGkRVnTzbU93YiqKP+lvHA==, figureFileBig=/P8aJHLE8Pk3MB3mYYbekQ==, tableContent=null), ArticleFig(id=1241050840413303779, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442542739751, language=CN, label=图1, caption=心理韧性在老年PLWHA社会支持与艾滋病相关压力之间的中介效应模型图

注：a、b为中介变量心理韧性的中介效应；c'为直接效应；**P<0.001。

, figureFileSmall=jGkRVnTzbU93YiqKP+lvHA==, figureFileBig=/P8aJHLE8Pk3MB3mYYbekQ==, tableContent=null), ArticleFig(id=1241050840547521517, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442542739751, language=EN, label=Table 1, caption=

Univariate analysis of HIV/AIDS-related stress in elderly PLWHA（)

, figureFileSmall=null, figureFileBig=null, tableContent=
变量人数构成比（%）情绪压力得分社会压力得分工具性压力得分总分
性别
男28069.145.31±5.3814.32±6.214.37±4.6124.00±13.08
女12530.867.23±7.0014.02±6.225.47±4.9626.73±15.81
t值-2.7270.440-2.169-1.686
P值0.0070.6600.0310.093
年龄（岁）
50～5921653.335.7±5.8914.86±5.985.02±4.7225.59±13.61
60～6915237.535.38±6.2813.59±6.534.35±4.8824.32±15.08
≥70379.145.14±5.2613.16±5.884.38±4.2022.68±11.6
F值0.9102.5011.0040.855
P值0.4030.0830.3670.426
户籍类型
农村18545.686.17±6.4914.24±6.265.95±4.9026.36±15.05
城镇22054.325.69±5.5214.22±6.173.67±4.3423.57±12.98
t值0.7950.0324.9191.973
P值0.4270.975<0.0010.049
民族
汉族40098.775.83±5.9414.17±6.214.68±4.7524.68±13.98
少数民族51.2311.8±7.3319.2±3.777±3.8138±11.05
t值-2.227-1.808-1.087-2.121
P值0.0260.0710.2780.035
文化程度
文盲122.969.83±9.6814.42±6.757.5±7.3731.75±20.73
小学8420.745.9±6.2514.31±6.195.77±4.725.99±14.67
初中15438.026.18±6.1814.2±6.285.12±4.8725.51±14.47
高中/中专10225.195.53±4.8613.55±6.213.81±4.122.89±12.32
大专327.905.38±6.6715.63±5.593.19±4.6924.19±13.71
本科及以上215.194.29±3.8215.14±6.622.52±2.8221.95±10.59
F值1.2090.6625.0451.358
P值0.3140.652<0.0010.239
婚姻状况
未婚163.957.5±7.314.25±7.096.69±6.5228.44±17.3
已婚/同居28971.365.21±5.7314.64±6.144.38±4.424.24±13.47
离异/分居7518.527.67±6.3613.4±6.225.6±5.4126.67±15.45
丧偶256.177.68±5.5411.88±5.974.56±4.7524.12±13.43
F值4.7152.0861.5870.977
P值0.0030.1020.2060.403
工作状态
在业15839.015.32±5.3814.47±6.574.49±4.4324.28±13.32
失业/无业11528.406.37±7.3314.95±5.555.55±5.4526.86±15.55
离/退休11628.645.82±5.2512.68±6.153.58±3.8922.08±12.66
务农163.9510±4.7418.62±3.7510.31±4.1938.92±9.99
F值3.9278.64811.6127.038
P值0.013<0.001<0.001<0.001
家庭人均月收入（元）
<2 40017342.726.44±6.9315.55±5.456±5.2927.99±14.78
2 400～7 19919147.165.7±5.0113.36±6.364.04±4.1223.09±12.77
≥7 2004110.124.63±5.7412.68±7.462.39±3.3119.71±13.59
F值1.6127.48616.0538.953
P值0.2040.001<0.001<0.001
确诊时长（年）
<1409.887.5±8.1613.18±7.095.78±5.6526.45±18.89
1～26115.066.41±6.0213.64±6.684.7±4.8924.75±14.75
3～513032.105.85±5.3414.92±5.694.45±4.1225.22±11.76
>517442.965.4±5.8214.16±6.194.67±4.8924.23±14.09
F值1.0491.0600.8120.248
P值0.3730.3690.4880.863
共病情况
无共病23558.025.39±5.7713.73±6.254.22±4.4923.34±13.62
有共病17041.986.62±6.2114.92±6.15.39±526.93±14.32
t值-2.043-1.910-2.483-2.564
P值0.0420.0570.0130.011
疾病分期a
Ⅰ期17944.205.59±5.7414.25±6.314.22±4.4724.06±13.65
Ⅱ期8220.256.76±5.7715.10±5.655.71±4.9527.56±13.55
Ⅲ期9122.475.59±6.5213.25±6.364.21±4.7723.05±14.78
Ⅳ期5313.096.21±6.1914.47±6.345.68±4.9826.36±14.22
F值0.8491.3162.9621.927
P值0.4680.2690.0320.125
), ArticleFig(id=1241050840769819636, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442542739751, language=CN, label=表1, caption=

老年PLWHA艾滋病相关压力单因素分析（）

, figureFileSmall=null, figureFileBig=null, tableContent=
变量人数构成比（%）情绪压力得分社会压力得分工具性压力得分总分
性别
男28069.145.31±5.3814.32±6.214.37±4.6124.00±13.08
女12530.867.23±7.0014.02±6.225.47±4.9626.73±15.81
t值-2.7270.440-2.169-1.686
P值0.0070.6600.0310.093
年龄（岁）
50～5921653.335.7±5.8914.86±5.985.02±4.7225.59±13.61
60～6915237.535.38±6.2813.59±6.534.35±4.8824.32±15.08
≥70379.145.14±5.2613.16±5.884.38±4.2022.68±11.6
F值0.9102.5011.0040.855
P值0.4030.0830.3670.426
户籍类型
农村18545.686.17±6.4914.24±6.265.95±4.9026.36±15.05
城镇22054.325.69±5.5214.22±6.173.67±4.3423.57±12.98
t值0.7950.0324.9191.973
P值0.4270.975<0.0010.049
民族
汉族40098.775.83±5.9414.17±6.214.68±4.7524.68±13.98
少数民族51.2311.8±7.3319.2±3.777±3.8138±11.05
t值-2.227-1.808-1.087-2.121
P值0.0260.0710.2780.035
文化程度
文盲122.969.83±9.6814.42±6.757.5±7.3731.75±20.73
小学8420.745.9±6.2514.31±6.195.77±4.725.99±14.67
初中15438.026.18±6.1814.2±6.285.12±4.8725.51±14.47
高中/中专10225.195.53±4.8613.55±6.213.81±4.122.89±12.32
大专327.905.38±6.6715.63±5.593.19±4.6924.19±13.71
本科及以上215.194.29±3.8215.14±6.622.52±2.8221.95±10.59
F值1.2090.6625.0451.358
P值0.3140.652<0.0010.239
婚姻状况
未婚163.957.5±7.314.25±7.096.69±6.5228.44±17.3
已婚/同居28971.365.21±5.7314.64±6.144.38±4.424.24±13.47
离异/分居7518.527.67±6.3613.4±6.225.6±5.4126.67±15.45
丧偶256.177.68±5.5411.88±5.974.56±4.7524.12±13.43
F值4.7152.0861.5870.977
P值0.0030.1020.2060.403
工作状态
在业15839.015.32±5.3814.47±6.574.49±4.4324.28±13.32
失业/无业11528.406.37±7.3314.95±5.555.55±5.4526.86±15.55
离/退休11628.645.82±5.2512.68±6.153.58±3.8922.08±12.66
务农163.9510±4.7418.62±3.7510.31±4.1938.92±9.99
F值3.9278.64811.6127.038
P值0.013<0.001<0.001<0.001
家庭人均月收入（元）
<2 40017342.726.44±6.9315.55±5.456±5.2927.99±14.78
2 400～7 19919147.165.7±5.0113.36±6.364.04±4.1223.09±12.77
≥7 2004110.124.63±5.7412.68±7.462.39±3.3119.71±13.59
F值1.6127.48616.0538.953
P值0.2040.001<0.001<0.001
确诊时长（年）
<1409.887.5±8.1613.18±7.095.78±5.6526.45±18.89
1～26115.066.41±6.0213.64±6.684.7±4.8924.75±14.75
3～513032.105.85±5.3414.92±5.694.45±4.1225.22±11.76
>517442.965.4±5.8214.16±6.194.67±4.8924.23±14.09
F值1.0491.0600.8120.248
P值0.3730.3690.4880.863
共病情况
无共病23558.025.39±5.7713.73±6.254.22±4.4923.34±13.62
有共病17041.986.62±6.2114.92±6.15.39±526.93±14.32
t值-2.043-1.910-2.483-2.564
P值0.0420.0570.0130.011
疾病分期a
Ⅰ期17944.205.59±5.7414.25±6.314.22±4.4724.06±13.65
Ⅱ期8220.256.76±5.7715.10±5.655.71±4.9527.56±13.55
Ⅲ期9122.475.59±6.5213.25±6.364.21±4.7723.05±14.78
Ⅳ期5313.096.21±6.1914.47±6.345.68±4.9826.36±14.22
F值0.8491.3162.9621.927
P值0.4680.2690.0320.125
), ArticleFig(id=1241050840937591807, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442542739751, language=EN, label=Table 2, caption=

Correlation among dimensions of social support, resilience, and HIV/AIDS-related stress (Pearson correlation, r value)

, figureFileSmall=null, figureFileBig=null, tableContent=
变量社会支持心理韧性情绪压力社会压力工具性压力艾滋病相关压力总分
社会支持—
心理韧性0.224**—
情绪压力-0.591**-0.176**—
社会压力-0.267**-0.207**0.457**—
工具性压力-0.493**-0.230**0.686**0.455**—
艾滋病相关压力总分-0.537**-0.245**0.861**0.792**0.832**—
), ArticleFig(id=1241050841109557249, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442542739751, language=CN, label=表2, caption=

社会支持、心理韧性和艾滋病相关压力各维度的相关性（Pearson相关，r值）

, figureFileSmall=null, figureFileBig=null, tableContent=
变量社会支持心理韧性情绪压力社会压力工具性压力艾滋病相关压力总分
社会支持—
心理韧性0.224**—
情绪压力-0.591**-0.176**—
社会压力-0.267**-0.207**0.457**—
工具性压力-0.493**-0.230**0.686**0.455**—
艾滋病相关压力总分-0.537**-0.245**0.861**0.792**0.832**—
), ArticleFig(id=1241050841268940815, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442542739751, language=EN, label=Table 3, caption=

Multiple linear regression analysis of HIV/AIDS-related stress in elderly PLWHA

, figureFileSmall=null, figureFileBig=null, tableContent=
维度变量标准化回归系数 t值P值
情绪压力常数—1.68611.083<0.001
心理韧性-0.5590.033-13.246<0.001
社会压力常数—1.79813.589<0.001
工作状态（ref：在业）
离/退休-0.1390.719-2.6420.009
社会支持-0.1140.043-2.2270.026
心理韧性-0.2280.039-4.715<0.001
工具性压力常数—1.7128.491<0.001
工作状态（ref：在业）
离/退休-0.1170.503-2.4270.016
务农0.1591.2153.519<0.001
家庭人均月收入（ref：<2 400）
≥7 200-0.1080.782-2.1580.032
共病情况（ref：无共病）
患有共病0.0910.4072.1480.032
疾病分期（ref：Ⅰ期）
Ⅱ期0.1030.532.280.023
心理韧性-0.4320.027-9.905<0.001
艾滋病相关压力总分常数—3.59716.104<0.001
工作状态（ref：在业）
离/退休-0.091.412-1.9780.049
务农0.1553.3773.635<0.001
社会支持-0.1160.081-2.6920.007
心理韧性-0.4950.077-11.702<0.001
共病情况（ref：无共病）
患有共病0.0951.1572.3370.02
), ArticleFig(id=1241050841449295894, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442542739751, language=CN, label=表3, caption=

老年PLWHA的艾滋病相关压力多元线性回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
维度变量标准化回归系数 t值P值
情绪压力常数—1.68611.083<0.001
心理韧性-0.5590.033-13.246<0.001
社会压力常数—1.79813.589<0.001
工作状态（ref：在业）
离/退休-0.1390.719-2.6420.009
社会支持-0.1140.043-2.2270.026
心理韧性-0.2280.039-4.715<0.001
工具性压力常数—1.7128.491<0.001
工作状态（ref：在业）
离/退休-0.1170.503-2.4270.016
务农0.1591.2153.519<0.001
家庭人均月收入（ref：<2 400）
≥7 200-0.1080.782-2.1580.032
共病情况（ref：无共病）
患有共病0.0910.4072.1480.032
疾病分期（ref：Ⅰ期）
Ⅱ期0.1030.532.280.023
心理韧性-0.4320.027-9.905<0.001
艾滋病相关压力总分常数—3.59716.104<0.001
工作状态（ref：在业）
离/退休-0.091.412-1.9780.049
务农0.1553.3773.635<0.001
社会支持-0.1160.081-2.6920.007
心理韧性-0.4950.077-11.702<0.001
共病情况（ref：无共病）
患有共病0.0951.1572.3370.02
), ArticleFig(id=1241050841684176926, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442542739751, language=EN, label=Table 4, caption=

Analysis of the mediating effect of resilience between social support and HIV/AIDS-related stress

, figureFileSmall=null, figureFileBig=null, tableContent=
路径效应效应值（95%CI） 效应占比（%）
社会支持→心理韧性→艾滋病相关压力中介效应-0.211（-0.335～-0.093）0.06240.81
直接效应-0.306（-0.513～-0.109）0.10459.19
总效应-0.517（-0.734～-0.297）0.110
), ArticleFig(id=1241050841914863654, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034442542739751, language=CN, label=表4, caption=

心理韧性在社会支持与艾滋病相关压力间的中介效应分析

, figureFileSmall=null, figureFileBig=null, tableContent=
路径效应效应值（95%CI） 效应占比（%）
社会支持→心理韧性→艾滋病相关压力中介效应-0.211（-0.335～-0.093）0.06240.81
直接效应-0.306（-0.513～-0.109）0.10459.19
总效应-0.517（-0.734～-0.297）0.110
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老年HIV感染者/AIDS患者感知压力现状及影响因素分析
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许鑫慧 1 , 曹桂英 2 , 李佳 1 , 陈钟 2 , 顾仁君 1 , 胡婧 1 , 谢建平 2 , 王红妹 1
现代预防医学 | 流行病与统计方法 2025,52(11): 1928-1934
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现代预防医学 | 流行病与统计方法 2025, 52(11): 1928-1934
老年HIV感染者/AIDS患者感知压力现状及影响因素分析
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许鑫慧1, 曹桂英2, 李佳1, 陈钟2, 顾仁君1, 胡婧1, 谢建平2 , 王红妹1
作者信息
  • 1.浙江大学公共卫生学院社会医学系，浙江 杭州 310058
  • 2.长沙市第一医院感染与免疫科，湖南 长沙 410001

    • 许鑫慧（2000—），女，硕士在读，研究方向：社会医学与卫生事业管理；

    曹桂英（1987—），女，硕士，主管护师，研究方向：艾滋病的护理及管理；

通讯作者:

王红妹与谢建平为共同通信作者。王红妹，E-mail:；
谢建平，E-mail:；
Analysis of the perceived stress status and influencing factors among elderly HIV-infected individuals/AIDS patients
Xin-hui XU1, Gui-ying CAO2, Jia LI1, Zhong CHEN2, Ren-jun GU1, Jing HU1, Jian-ping XIE2 , Hong-mei WANG1
Affiliations
  • Department of Social Medicine, School of Public Health, Zhejiang University, Hangzhou, Zhejiang 310058, China
出版时间: 2025-06-10 doi: 10.20043/j.cnki.MPM.202411041
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摘要
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目的

分析老年HIV感染者/AIDS患者（people living with HIV/AIDS，PLWHA）感知艾滋病相关压力的现状及其影响因素，探讨心理韧性在社会支持和艾滋病相关压力之间的中介作用。

方法

于2024年1—2月采用方便抽样法，纳入长沙市传染病医院感染与免疫科门诊405名老年PLWHA为研究对象。现场问卷调查内容包括社会支持评定量表（social support rating scale，SSRS）、简版心理韧性量表（10-item connor-davidson resilience scale，CD-RISC-10）、艾滋病相关压力量表（Chinese HIV/AIDS stress scale，CSS-HIV）以及社会人口学与疾病特征信息。通过描述性分析、单因素分析和多元逐步线性回归分析艾滋病相关压力现状及其影响因素；通过中介效应分析探索心理韧性对艾滋病相关压力的中介作用。

结果

老年PLWHA的艾滋病相关压力总分为（24.84±14.01）分，其中情绪压力为（5.91±5.98）分、社会压力为（14.23±6.21）分、工具性压力为（4.71±4.74）分。离/退休或务农、患有共病、社会支持和心理韧性水平是艾滋病相关压力的影响因素（P<0.05）。心理韧性在社会支持与艾滋病相关压力的关系中存在部分中介效应，中介效应占比为40.81%。

结论

老年PLWHA的心理韧性对艾滋病相关压力发挥部分中介影响。以改善社会支持现状，提升患者心理韧性水平为目标展开干预研究，将有助于缓解艾滋病相关压力，减轻其心理负担和痛苦。

老年HIV感染者/AIDS患者  /  社会支持  /  心理韧性  /  艾滋病相关压力  /  中介效应
Objective

To analyze the current status of perceived HIV/AIDS-related stress among elderly individuals living with HIV/AIDS (PLWHA) and its influencing factors, and to explore the mediating role of psychological resilience between social support and HIV/AIDS-related stress.

Methods

A convenience sampling method was employed to include 405 elderly PLWHA from the Infectious Diseases and Immunology Department of Changsha Infectious Disease Hospital between January and February 2024. The on-site questionnaire included the Social Support Rating Scale (SSRS), the 10-item Connor-Davidson Resilience Scale (CD-RISC-10), the Chinese HIV/AIDS Stress Scale (CSS-HIV), as well as demographic and disease characteristic information. Descriptive analysis, univariate analysis, and multiple stepwise linear regression were used to analyze the current status and influencing factors of HIV/AIDS-related stress; mediation analysis was conducted to explore the mediating effect of psychological resilience on HIV/AIDS-related stress.

Results

The total score for HIV/AIDS-related stress among elderly PLWHA was 24.84±14.01, with emotional stress scoring 5.91±5.98,social stress 14.23±6.21, and instrumental stress 4.71±4.74. Factors influencing HIV/AIDS-related stress included being retired or engaged in farming, comorbidities, levels of social support, and psychological resilience (P<0.05). Psychological resilience showed a partial mediating effect in the relationship between social support and HIV/AIDS-related stress, accounting for 40.81% of the mediation effect.

Conclusion

Psychological resilience partially mediates the impact of social support on HIV/AIDS-related stress among elderly PLWHA. Interventions aimed at improving the status of social support and enhancing the psychological resilience of patients may help alleviate HIV/AIDS-related stress, thereby reducing their psychological burden and suffering.

Elderly HIV-infected individuals/AIDS patients  /  Social support  /  Psychological resilience  /  HIV/AIDS-related stress  /  Mediating effect
许鑫慧, 曹桂英, 李佳, 陈钟, 顾仁君, 胡婧, 谢建平, 王红妹. 老年HIV感染者/AIDS患者感知压力现状及影响因素分析. 现代预防医学, 2025 , 52 (11) : 1928 -1934 . DOI: 10.20043/j.cnki.MPM.202411041
Xin-hui XU, Gui-ying CAO, Jia LI, Zhong CHEN, Ren-jun GU, Jing HU, Jian-ping XIE, Hong-mei WANG. Analysis of the perceived stress status and influencing factors among elderly HIV-infected individuals/AIDS patients[J]. Modern Preventive Medicine, 2025 , 52 (11) : 1928 -1934 . DOI: 10.20043/j.cnki.MPM.202411041
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在艾滋病研究领域，通常将老年HIV感染者/AIDS患者（people living with HIV/AIDS，PLWHA）的年龄界定为50周岁及以上[1]。近年来，抗逆转录病毒疗法（anti-retroviral therapy，ART）延长了患者生存年限，促使现存老年PLWHA占比逐年升高[2]，老年艾滋病疫情逐渐成为我国艾滋病防控领域不容忽视的问题。由于目前艾滋病的不可治愈性及相关歧视和污名化的存在[3]，老年PLWHA承受着诸多艾滋病相关的压力和痛苦。例如，在生理方面，药物不良反应和免疫力低下更易引起或加重其他疾病[4-5]；在心理和社会方面，对于艾滋病的羞耻感、自卑感以及社会歧视等，导致患者出现严重的焦虑、抑郁，甚至自杀倾向等[6-7]。
社会支持是指个人在社会关系中得到的各种形式的支持、帮助和赞同，对个体心理健康水平具有积极影响。既往大量研究表明社会支持与压力存在紧密联系，良好的社会支持网络可以减轻个体压力、焦虑和抑郁的程度[7]，高水平的社会支持可以降低PLWHA的压力[8]。
尽管外界的社会支持水平对患者感知的压力有一定影响，个体内在的心理韧性或许在一定程度能减轻较弱的社会支持水平对压力带来的不良影响。心理韧性是指个体在面对压力、逆境或挑战时，通过积极适应和调整，能够乐观面对、恢复或迅速适应的能力。心理韧性水平越高，患者产生压力、焦虑、抑郁等负面情绪的概率就越低[9]。已有研究表明，心理韧性也是PLWHA压力的重要影响因素之一，且在PLWHA的社会支持、压力与生命质量关系中均发挥中介作用[10-11]。而目前尚少探讨老年PLWHA压力的影响因素，以及个体的心理韧性水平在社会支持和压力间的影响。Kumpfer[12]的心理韧性框架理论强调个体面对逆境时，如何通过内外部保护性因素的作用实现积极适应的过程。故本研究旨在探索老年PLWHA压力现状及其影响因素，以Kumpfer的心理韧性框架理论为依据，进一步分析心理韧性在社会支持与艾滋病相关压力间的中介作用，为缓解患者艾滋病相关压力水平、改善其生命质量提供参考依据。
1　对象与方法
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1.1　研究现场与研究对象
本研究于2024年1—2月，采用方便抽样法，选取50周岁及以上的老年PLWHA为研究对象，在长沙市传染病医院的感染与免疫科HIV门诊开展现场问卷调查。研究对象纳入标准：实验室检查确诊为HIV阳性；50周岁及以上者；能够正常表达和沟通；档案资料完整；自愿参加本研究。排除标准：精神或认知能力异常，无法正常理解和沟通者。本研究通过浙江大学医学院附属第一医院（编号：2022-IRB-292）和长沙市第一医院（编号：KX-2021028）伦理委员会批准。
1.2　调查过程与工具
调查员工作前接受统一培训，在调查前首先口头招募，向患者介绍调查目的与内容，同意参与者要求其签署知情同意书。调查员使用自行设计的调查问卷在独立房间对研究对象进行一对一调查，调查问卷内容如下。
（1）一般人口学信息，包括患者的性别、年龄、婚姻状况、民族、文化程度、户籍类型、工作状况等；根据病历资料收集患者的确诊时长、患共病情况和最近一次CD4计数。
（2）艾滋病相关压力：采用牛璐等[13]修订的中文版艾滋病相关压力量表（Chinese HIV/AIDS stress scale，CSS-HIV）调查研究对象近一个月以来经历的艾滋病相关压力事件，共17个条目，包括情绪压力（6条目，0～24分）、社会压力（6条目，0～24分）和工具性压力（5条目，0～20分）三个维度。采用Likert 5级计分法（0～4分），总分范围为0～68分，得分越高表明研究对象近期艾滋病相关压力越大。本研究中该量表的内部一致性系数为0.900。
（3）心理韧性：采用简版心理韧性量表（Connor-Davidson resilience scale，CD-RISC-10）调查研究对象的心理韧性水平[14]，共10个条目。采用Likert 5级计分法，总分范围为0～40分，得分越高表明研究对象的心理韧性水平越高。本研究中该量表的内部一致性系数为0.951。
（4）社会支持：采用肖水源编制的社会支持评定量表（social support rating scale，SSRS）调查研究对象的社会支持情况[15]，包括客观支持、主观支持和社会支持利用度三个维度，共10个条目。10个条目计分之和即为社会支持状况总分，得分越高表明研究对象的社会支持状况越好。本研究中该量表的内部一致性系数为0.704。
1.3　统计学方法
使用SPSS 21.0软件对数据进行统计分析。描述性分析中，连续型资料采用（）描述，分类资料采用频数和构成比描述；单因素分析中，连续型变量使用t/F检验，分类变量使用χ2检验，社会支持、心理韧性与压力之间的相关性使用Pearson相关分析。将单因素分析中有统计学意义的变量，采用逐步法纳入多元线性回归分析，探索压力各维度的影响因素，选入自变量的检验水平α入=0.05，剔除自变量的检验水平α出=0.10。采用Process插件进行心理韧性在社会支持与压力之间的中介效应分析和bootstrap法检验中介效应，95%CI不包括0，表明中介效应显著。检验水准α=0.05。
2　结果
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2.1　调查对象基本情况
本研究共纳入研究对象405人，平均年龄为（59.34±7.0）岁，确诊时长为（5.44±4.08）年。以男性、已婚/同居、城镇户口、汉族、无共病、处于疾病Ⅰ期为主，分别为69.14%、71.36%、54.32%、98.77%、58.02%、44.20%。见表1。
2.2　不同人口学特征患者社会支持、心理韧性、艾滋病相关压力得分情况
405例患者社会支持总分为（36.34±7.39）分，心理韧性总分为（28.22±7.67）分。压力总分为（24.84±14.01）分，其中情绪压力维度得分（5.91±5.98）分，社会压力维度得分（14.23±6.21）分，工具性压力维度得分（4.71±4.74）分。
不同性别、民族、婚姻状况、工作状态和患共病情况对老年PLWHA情绪压力的影响具有统计学意义（P<0.05）；不同工作状态和家庭人均月收入水平对老年PLWHA社会压力的影响具有统计学意义（P<0.05）；不同性别、户籍类型、文化程度、工作状态、家庭人均月收入水平、患共病情况和疾病分期影响老年PLWHA的工具性压力（P<0.05）；不同户籍类型、民族、工作状态、家庭人均月收入水平和患共病情况影响老年PLWHA的压力总分（P<0.05）。见表1。
2.3　社会支持与心理韧性、艾滋病相关压力的相关性分析
老年PLWHA社会支持得分与心理韧性得分呈正相关（r=0.224，P<0.01）；社会支持得分与压力得分呈负相关（r=-0.537，P<0.01）；心理韧性得分与压力得分呈负相关（r=-0.245，P<0.01）。见表2。
2.4　艾滋病相关压力多因素分析
以压力总分和各维度得分作为因变量，将社会支持得分、心理韧性得分和单因素分析有统计学意义的自变量按逐步法纳入多元线性回归模型。结果显示，老年PLWHA的心理韧性水平对情绪压力有负向影响。离/退休、高水平社会支持和心理韧性对老年PLWHA的社会压力有负向影响。离/退休、高人均月收入和高水平心理韧性对老年PLWHA的工具性压力有负向影响；务农、患有共病和处于疾病Ⅱ期是其工具性压力的危险因素。离/退休、高水平社会支持心理韧性对压力总分有负向影响；务农、患有共病是压力总分的危险因素。见表3。
2.5　心理韧性在患者社会支持与艾滋病相关压力之间的中介效应
以社会支持为自变量，心理韧性为中介变量，艾滋病相关压力为因变量，进行中介效应分析后结果显示，社会支持可预测心理韧性（a=0.232,P<0.001），社会支持和心理韧性均进入回归方程，社会支持可预测压力（c’=-0.306，P<0.001），心理韧性可预测压力（b=-0.910,P<0.001）。Bootstrap法检验显示，心理韧性在老年PLWHA社会支持与艾滋病相关压力之间发挥部分中介效应，中介效应（-0.211）和直接效应（-0.306）分别占总效应（-0.517）的40.81%和59.19%，以心理韧性为中介模型的总效应、中介效应和直接效应的95%CI均不包含0。见表4和图1。
3　讨论
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本研究中，老年PLWHA的艾滋病相关压力得分为（24.84±14.01）分，高于黄云香等[16]的研究。压力主要来源于社会压力维度，与已有研究结果一致[17]。在我国，PLWHA面临的歧视与污名化现象较为突出。这一现状使得部分患者对于个人隐私的保护呈现出过度敏感的态度，进而导致其在社会生活中承受着较大的心理压力。同时，老年PLWHA群体由于生理机能衰退、信息获取途径受限及社交网络的缩减而面临更多的挑战，进一步加剧了其压力。
本研究发现，老年PLWHA的社会支持水平与心理韧性水平呈正相关，且社会支持、心理韧性水平与压力水平呈负相关。社会支持水平高者能获得更为丰富的情感和物质资源，有助于增强其归属感和自信心，从而在面对自己的病情或生活变故时表现出更高的心理韧性[18]。而心理韧性水平高者具备更强的适应和自我调节能力，即便遭遇逆境仍能与外界积极交流，从而收获更多的社会支持[19]。已有研究证实[20]，充分的社会支持有助于减轻压力，提高患者的身心健康水平。PLWHA普遍承受着沉重的心理负担，心理韧性水平较低，易产生焦虑、抑郁和自我厌弃等负面情绪，导致其选择自我封闭、向亲友隐瞒自己的感染状况，从而拒绝利用或失去现有的社会支持[21]，无法改善自身压力。
研究结果显示，工作状态、共病情况、社会支持和心理韧性水平是老年PLWHA压力的影响因素。务农者因经济来源和收入水平受限往往易感到压力[22]；离/退休人群的社交活动和职业需求相对减少，因而较少产生压力；此外，患共病者相对于未患共病者对医疗服务的需求更为迫切，然而受制于疾病的特殊性，这些患者往往无法获得与一般人群相同水平的医疗服务，故而面临更高压力。社会支持和心理韧性水平更高者压力较小，与已有研究一致[8,23]。
进一步中介效应分析显示，心理韧性在社会支持与压力之间发挥中介作用，即较高的社会支持水平一方面会直接对压力产生负向影响，另一方面可通过增强其心理韧性水平来减轻其压力。心理韧性与患者当前社会支持环境交互作用可重组其心理系统，使其对当前不利环境产生良好适应或成功应对，降低其感知压力水平[24]。因此为有效减轻老年PLWHA的压力，除增加患者的社会支持外，还需关注其心理韧性水平。可针对性地对患者进行健康宣教和心理疏导，提高其心理韧性以减轻压力。加强政府、社区和医疗机构的合作，通过疾病知识普及与反歧视宣传，减少社会公众对艾滋病的污名化和歧视，增强患者的社会认同感。开展以家庭为单位的支持性干预措施，改善其心理状态，从而帮助患者更好地寻求和利用社会支持，减轻其压力。
综上，老年PLWHA的艾滋病相关压力主要集中在社会压力维度，不同维度存在不同影响因素。以改善社会支持现状，提升患者心理韧性水平为目标展开干预研究，将有助于缓解老年PLWHA的艾滋病相关压力，减轻其心理负担和痛苦。
基金
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  • 国家自然科学基金(72174177)
文献
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参考文献 引证文献
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2025年第52卷第11期
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doi: 10.20043/j.cnki.MPM.202411041
  • 接收时间：2024-11-04
  • 首发时间：2026-03-18
  • 出版时间：2025-06-10
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  • 收稿日期：2024-11-04
基金
国家自然科学基金(72174177)
作者信息
    1.浙江大学公共卫生学院社会医学系，浙江 杭州 310058
    2.长沙市第一医院感染与免疫科，湖南 长沙 410001

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王红妹与谢建平为共同通信作者。王红妹，E-mail:；
谢建平，E-mail:；
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2种不同金属材料的力学参数
科
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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