慢性病患者自我损耗的概念分析

doi:10.3761/j.issn.1672-9234.2023.08.012

摘要/Abstract

摘要：

目的探讨慢性病患者自我损耗概念的定义及其内涵，为开展自我损耗相关研究提供参考。方法系统检索1998年—2022年发表在CINAHL、PubMed、Cochrane Library、Web of Science、Embase、知网、中国生物医学文献服务系统、万方数据库中的关于自我损耗的文献。采用Walker和Avant的概念分析法对纳入文献进行分析。结果共纳入39篇文献。慢性病患者自我损耗的定义属性为心理资源消耗、自我控制能力下降，且两者交互影响；其前因为疾病相关因素、人口学特征、睡眠因素、认知因素、心理社会因素；后果为不良健康行为、心理负担加重及生活质量下降。测量工具包括自我调节疲劳量表、自我损耗后效量表和自我损耗源量表。结论该研究明晰了慢性病患者自我损耗的定义属性、前因及后果，可为以后开展慢性病自我损耗评估工具开发、理论模型构建及干预研究等提供参考。

关键词: 慢性病, 护理, 自我损耗, 概念分析

Abstract:

Objective To explore the definition and connotation of the concept of ego-depletion in patients with chronic diseases，and to lay a foundation for the related research of ego-depletion. Methods Literature on ego-depletion from 1998 to 2022 in CINAHL，PubMed，Cochrane Library，Web of Science，Embase，CNKI，SinoMed databases and Wanfang Database were systematically searched. Walker and Avant’s conceptual analysis method was used to carry out conceptual analysis of the included literatures. Results A total of 39 articles were listed. The definition of ego-depletion included mental resource consumption，self-control ability decline and their interaction； The leading factors were disease related factors，demographic characteristics，sleep factors，cognitive factors，and psychosocial factors； The consequence included negative health behaviors，increased psychological burden and reduced quality of life. The measuring tools included Self-Regulatory Fatigue Scale，Ego Depletion Aftereffects Scale，and Ego Depletion Source Scale. Conclusion This study clarified the defining attributes，antecedents and consequences of ego-depletion in patients with chronic diseases，laid a foundation for the development of assessment tools，theoretical model construction and intervention research of ego-depletion in chronic disease in the future.

Key words: Chronic Disease, Nursing Care, Ego-depletion, Concept analysis

孙姝怡, 孙国珍, 高敏, 于甜栖, 刘沈馨雨, 王洁. 慢性病患者自我损耗的概念分析[J]. 中华护理教育, 2023, 20(8): 963-968.

SUN Shuyi, SUN Guozhen, GAO Min, YU Tianqi, LIU Shenxinyu, WANG Jie. A concept analysis of ego-depletion in patients of chronic diseases[J]. Chinese Journal of Nursing Education, 2023, 20(8): 963-968.

参考文献 45

[1]	World health statistics 2021:monitoring health for the SDGs,sustainable development goals[EB/OL].[2022-12-02]. https://creativecommons.org/licenses/by-nc-sa/3.0/igo/.
[2]	熊智. 我国慢性病防治面临的挑战与对策[J]. 中国慢性病预防与控制, 2019, 27(9):720-721.
	Xiong Z. Challenges and countermeasures of chronic disease prevention and treatment in China[J]. Chin J Prev Control Chronic Dis, 2019, 27(9):720-721.
[3]	陈冬, 逄冬, 隋树杰, 等. 慢性病患者自我损耗研究进展[J]. 中国实用护理杂志, 2021, 37(32):2557-2560,F0003.
	Chen D, Pang D, Sui SJ, et al. Research progress of ego-deple-tion in patients of chronic diseases[J]. Chin J Pract Nurs, 2021, 37(32):2557-2560,F0003.
[4]	Baumeister RF, Bratslavsky E, Muraven M, et al. Ego depletion:is the active self a limited resource?[J]. J Pers Soc Psychol, 1998, 74(5):1252-1265. doi: 10.1037//0022-3514.74.5.1252 pmid: 9599441
[5]	Nes LS, Roach AR, Segerstrom SC. Executive functions,self-reg-ulation,and chronic pain:a review[J]. Ann Behav Med, 2009, 37 (2):173-183. doi: 10.1007/s12160-009-9096-5
[6]	Bonis SA. Concept analysis:method to enhance interdisciplinary conceptual understanding[J]. ANS Adv Nurs Sci, 2013, 36(2):80-93. doi: 10.1097/ANS.0b013e318290d86e
[7]	Walker LO, Avant KC. Strategies for theory construction in nursing[M]. Appleton & Lange, 1995.
[8]	Hagger MS, Wood C, Stiff C, et al. Ego depletion and the strength model of self-control:a meta-analysis[J]. Psychol Bull, 2010, 136(4):495-525. doi: 10.1037/a0019486
[9]	Beedie CJ, Lane AM. The role of glucose in self-control:another look at the evidence and an alternative conceptualization[J]. Pers Soc Psychol Rev, 2012, 16(2):143-153. doi: 10.1177/1088868311419817
[10]	Evans DR, Boggero IA, Segerstrom SC. The nature of self-regulatory fatigue and “ego depletion”:lessons from physical fatigue[J]. Pers Soc Psychol Rev, 2016, 20(4):291-310. doi: 10.1177/1088868315597841
[11]	Baumeister RF, Tice DM, Vohs KD. The strength model of self-regulation:conclusions from the second decade of willpower research[J]. Perspect Psychol Sci, 2018, 13(2):141-145. doi: 10.1177/1745691617716946 pmid: 29592652
[12]	Baumeister RF, Vohs KD. Strength model of self-regulation as limited resource[M]//Advances in Experimental Social Psychology. Amsterdam:Elsevier, 2016:67-127.
[13]	Nes LS, Carlson CR, Crofford LJ, et al. Self-regulatory deficits in fibromyalgia and temporomandibular disorders[J]. Pain, 2010, 151(1):37-44. doi: 10.1016/j.pain.2010.05.009 pmid: 20561749
[14]	高倩, 李晓敏, 孙王乐贤, 等. 自我调节疲劳对冠心病患者自我管理行为的影响[J]. 中国慢性病预防与控制, 2019, 27(1):38-42.
	Gao Q, Li XM, Li WLX, et al. Effect of self-regulated fatigue on self-management behavior of patients with coronary heart disease[J]. Chin J Prev Control Chronic Dis, 2019, 27(1):38-42.
[15]	于斌, 乐国安, 刘惠军. 自我控制的力量模型[J]. 心理科学进展, 2013, 21(7):1272-1282. doi: 10.3724/SP.J.1042.2013.01272
[16]	Nes LS, Ehlers SL, Whipple MO, et al. Self-regulatory fatigue in chronic multisymptom illnesses:scale development,fatigue,and self-control[J]. J Pain Res, 2013, 6:181-188.
[17]	Hagger MS, Wood C, Stiff C, et al. The strength model of self-regulation failure and health-related behaviour[J]. Health Psychol Rev, 2009, 3(2):208-238. doi: 10.1080/17437190903414387
[18]	单亚维, 陈维佳, 金丽娟, 等. 全膝关节置换术后患者康复行为演变的质性研究[J]. 中华护理杂志, 2020, 55(10):1470-1475. doi: 10.3761/j.issn.0254-1769.2020.10.005
	Shan YW, Chen WJ, Jin LJ, et al. The development of rehabilitation behaviors of patients with total knee arthroplasty:a qualitative study[J]. Chin J Nurs, 2020, 55(10):1470-1475. doi: 10.3761/j.issn.0254-1769.2020.10.005
[19]	张梦倩, 李晓敏, 梁明明, 等. 经皮冠状动脉介入治疗(PCI)术后冠心病患者自我损耗现状及其影响因素[J]. 中国健康心理学杂志, 2020, 28(6):856-861.
	Zhang MQ, Li XM, Liang MM, et al. Analysis of the status quo and influencing factors of coronary heart disease patients after PCI[J]. China J Health Psychol, 2020, 28(6):856-861.
[20]	刘静, 冯艳, 徐多娇, 等. 2型糖尿病患者自我损耗的现状及影响因素分析[J]. 实用预防医学, 2021, 28(9):1105-1107.
	Liu J, Feng Y, Xu DJ, et al. Status quo and influencing factors of ego depletion in patients with type 2 diabetes mellitus[J]. Pract Prev Med, 2021, 28(9):1105-1107.
[21]	李飞, 崔雪英, 王利刚, 等. 颞下颌关节紊乱患者慢性疼痛与自我调节疲劳的关系[J]. 中国心理卫生杂志, 2019, 33(8):583-586.
	Li F, Cui XY, Wang LG, et al. Relationship between chronic pain and self-regulatiory fatigue in patients with temporo-mandibular joint disorders[J]. Chin Ment Health J, 2019, 33(8):583-586.
[22]	原小岚. 原发性三叉神经痛患者自我调节疲劳、自我效能感与生活质量的关系研究[D]. 济南: 山东大学, 2020.
	Yuan XL. The relationship among self-regulatory fatigue,self-efficacy and quality of life in patients with primary trigeminal neuralgia[D]. Jinan: Shandong University, 2020.
[23]	杜燕敏, 李睿, 田亚楠, 等. 2型糖尿病患者自我损耗现状及其对健康促进的影响[J]. 职业与健康, 2019, 35(6):798-801, 805.
	Du YM, Li R, Tian YN, et al. Ego depletion status and its impact on health promotion in patients with type 2 diabetes mellitus[J]. Occup Health, 2019, 35(6):798-801,805.
[24]	易子涵, 李茜, 张海茹, 等. 自我调节疲劳在中老年2型糖尿病患者睡眠质量与自我管理行为间的中介作用研究[J]. 重庆医学, 2021, 50(8):1394-1398.
	Yi ZH, Li Q, Zhang HR, et al. Study on mediating effect of self-regulation fatigue on sleep quality and self-management behavior in middle-aged and elderly patients with type 2 diabetes mellitus[J]. Chongqing Med, 2021, 50(8):1394-1398.
[25]	陆璐, 赵少勇, 戴春林. 睡眠质量对自我控制的影响:基于自我损耗理论的解释[J]. 中国健康心理学杂志, 2020, 28(7):1100-1105.
[26]	张妍欣, 杨丽, 李家燕, 等. 鼻咽癌放化疗患者自我调节疲乏现状及影响因素分析[J]. 解放军护理杂志, 2021, 38(4):17-20.
	Zhang YX, Yang L, Li JY, et al. Status quo and its influencing factors of self-regulating fatigue in nasopharyngeal carcinoma patients undergoing radiotherapy and chemotherapy[J]. Nurs J Chin PLA, 2021, 38(4):17-20.
[27]	周丽芳, 李琼, 阙巧艳. 心理弹性在中青年乳腺癌患者应对方式与自我调节疲劳关系中的中介作用研究[J]. 中国医院统计, 2021, 28(4):315-320.
	Zhou LF, Li Q, Que QY. Mediating effect of resilience on the relationship between coping style and self-regulatory fatigue in young and middle-aged breast cancer survivors[J]. Chin J Hosp Stat, 2021, 28(4):315-320.
[28]	Castonguay A, Miquelon P, Boudreau F. Self-regulation resour-ces and physical activity participation among adults with type 2 diabetes[J]. Health Psychol Open, 2018, 5(1):2055102917750331.
[29]	McMillan G, Dixon D. Self-regulatory processes,motivation to conserve resources and activity levels in people with chronic pain:a series of digital N-of-1 observational studies[J]. Front Psychol, 2020, 11:516485. doi: 10.3389/fpsyg.2020.516485
[30]	周越, 单岩, 李艳艳, 等. 自我调节疲劳对腹膜透析患者疾病管理积极度的影响[J]. 护理学杂志, 2020, 35(15):34-36.
	Zhou Y, Shan Y, Li YY, et al. Impact of self-regulatory fatigue on activation level among peritoneal dialysis patients[J]. J Nurs Sci, 2020, 35(15):34-36.
[31]	Wang LG, Yu Y, Tao T, et al. The self-care dilemma of type 2 diabetic patients:the mechanism of self-regulation resource depletion[J]. PLoS One, 2018, 13(12):e0208690.
[32]	汪敏, 李丹丹, 顾敏杰, 等. 正念及自我控制在糖尿病患者自我损耗与健康促进间的中介效应[J]. 护理学杂志, 2019, 34(24):26-28,63.
	Wang M, Li DD, Gu MJ, et al. Mediating effect of mindfulness and self-control on the relationship between ego-depletion and health promotion among diabetic patients[J]. J Nurs Sci, 2019, 34(24):26-28,63.
[33]	Solberg Nes L, Ehlers SL, Patten CA, et al. Self-regulatory fatigue,quality of life,health behaviors,and coping in patients with hematologic malignancies[J]. Ann Behav Med, 2014, 48(3):411-423. doi: 10.1007/s12160-014-9621-z pmid: 24802991
[34]	Li XM, Gao Q, Sun LX, et al. Effect of self-control on health promotion behavior in patients with coronary heart disease:mediating effect of ego-depletion[J]. Psychol Health Med, 2022, 27(6):1268-1276. doi: 10.1080/13548506.2020.1867316
[35]	Solberg Nes L, Ehlers SL, Patten CA, et al. Self-regulatory fatigue in hematologic malignancies:impact on quality of life,coping,and adherence to medical recommendations[J]. Int J Behav Med, 2013, 20(1):13-21. doi: 10.1007/s12529-011-9194-1 pmid: 21928059
[36]	Gao YJ, Shan Y, Jiang TT, et al. Dietary adherence,self-regulatory fatigue and trait self-control among Chinese patients with peritoneal dialysis:a cross-sectional study[J]. Patient Prefer Adherence, 2021, 15:443-451. doi: 10.2147/PPA.S298231
[37]	Fischer P, Greitemeyer T, Frey D. Ego depletion and positive illusions:does the construction of positivity require regulatory resources?[J]. Pers Soc Psychol Bull, 2007, 33(9):1306-1321. doi: 10.1177/0146167207303025
[38]	李佳益. 2型糖尿病患者自我调节疲劳、自我效能感与自我管理行为的相关性研究[D]. 济南: 山东大学, 2021.
	Li JY. Study on the correlation between self-regulatory fatigue,self-efficacy and self-management behaviors in patients with type 2 diabetes[D]. Jinan: Shandong University, 2021.
[39]	Bertrams A, Englert C, DickhUser O, et al. Role of self-control strength in the relation between anxiety and cognitive performance[J]. Emotion, 2013, 13(4):668-680. doi: 10.1037/a0031921 pmid: 23527509
[40]	韩莹. 自我调节疲劳与中青年乳腺癌患者术后残障接受度的相关性研究[J]. 海军医学杂志, 2019, 40(1):89-92.
	Han Y. Correlation between self-regulated fatigue and postoperative disability acceptance of young and middle-aged breast cancer patients[J]. J Navy Med, 2019, 40(1):89-92.
[41]	Nes LS, Ehlers SL, Whipple MO, et al. Self-regulatory fatigue:a missing link in understanding fibromyalgia and other chronic MultiSymptom illnesses[J]. Pain Pract, 2017, 17(4):460-469. doi: 10.1111/papr.2017.17.issue-4
[42]	王利刚, 张静怡, 王佳, 等. 自我调节疲劳量表中文版测评青年人的效度与信度[J]. 中国心理卫生杂志, 2015, 29(4):290-294.
	Wang LG, Zhang JY, Wang J, et al. Validity and reliability of the Chinese version of the Self-Regulatory Fatigue Scale in young adults[J]. Chin Ment Health J, 2015, 29(4):290-294.
[43]	唐义诚, 高文斌, 王经纬, 等. 研究生自我损耗后效量表的编制与信效度分析[J]. 中华行为医学与脑科学杂志, 2016, 25(9):851-854.
	Tang YC, Gao WB, Wang JW, et al. Development of the Ego Depletion Aftereffects Scale in Postgraduates[J]. Chin J Behav Med Brain Sci, 2016, 25(9):851-854.
[44]	唐义诚, 高文斌, 王经纬, 等. 自我损耗源量表的编制及测评研究生样本的信效度[J]. 中国心理卫生杂志, 2016, 30(11):851-857.
	Tang YC, Gao WB, Wang JW, et al. Development of the Ego Depletion Source Scale and the psychometric evaluation in postgraduates[J]. Chin Ment Health J, 2016, 30(11):851-857.
[45]	韩今华, 齐冲, 王毅. 老年不同慢性病患者睡眠质量与焦虑现状[J]. 中国老年学杂志, 2017, 37(16):4120-4121.
	Han JH, Qi C, Wang Y. Sleep quality and anxiety status of elderly patients with different chronic diseases[J]. Chin J Gerontol, 2017, 37(16):4120-4121.