慢性病患者主动控制感研究进展及护理启示

doi:10.3761/j.issn.1672-9234.2025.09.018

摘要/Abstract

摘要：

主动控制感是个体在主动行为中产生的控制自身动作进而控制外界环境的主观体验。若慢性病患者的主动控制感在疾病治疗管理过程中得以增强，则对其生理功能、情绪状态和健康管理均具有积极意义。该文对主动控制感的相关概念、测量方式及工具进行概述，归纳总结慢性病患者主动控制感的影响因素及干预措施。在此基础上提出慢性病患者主动控制感未来发展方向，以期为护理人员开展相关研究、制订慢性病患者主动控制感精准化干预方案，以提升患者的积极心理感受提供参考。

关键词: 慢性病, 主动控制感, 积极心理学, 心理护理, 综述

Abstract:

Sense of agency is defined as the subjective experience of an individual in active behavior to control their movements and thereby control the external environment. For patients with chronic disease，enhancing sense of agency in disease treatment and management can lead to psychological changes，which hold positive implications for their physiological functions，emotional states，and health management. This paper provided an overview of the concepts and measurement tools related to sense of agency，as well as a review of the influencing factors and interventions for sense of agency in patients with chronic disease. On this basis，it proposed future directions for the application of a sense of agency in patients with chronic diseases. The paper aims to provide references for nursing staffs to conduct relevant research，and to develop precise intervention programs for patients with chronic disease to enhance their positive psychological feelings.

Key words: Chronic disease, Sense of agency, Positive psychology, Psychological nursing, Review

段博美, 梅永霞, 王晓萱, 张杰, 张振香. 慢性病患者主动控制感研究进展及护理启示[J]. 中华护理教育, 2025, 22(9): 1141-1146.

DUAN Bomei, MEI Yongxia, WANG Xiaoxuan, ZHANG Jie, ZHANG Zhenxiang. Research progress on sense of agency of patients with chronic diseases[J]. Chinese Journal of Nursing Education, 2025, 22(9): 1141-1146.

参考文献 34

[1]	陈可欣, 王睆琳, 冯尘尘, 等. 国内外慢性病健康管理研究进展与对策分析[J]. 中国卫生事业管理, 2022, 39(9):717-720.
	Chen KX, Wang HL, Feng CC, et al. Research on the progress and countermeasures of health management of chronic diseases at home and abroad[J]. Chin Health Serv Manag, 2022, 39(9):717-720.
[2]	吴霞, 刘岚, 赵一, 等. 云南省农村居民2011年和2021年五种常见慢性病疾病负担的变化研究[J]. 中国全科医学, 2024, 27(13):1601-1607. doi: 10.12114/j.issn.1007-9572.2023.0276
	Wu X, Liu L, Zhao Y, et al. Changes in the burden of five common chronic diseases among rural residents in Yunnan Province in 2011 and 2021[J]. Chin Gen Pract, 2024, 27(13):1601-1607.
[3]	何雅, 曹学华, 吕琴, 等. 个人掌控感在慢性病患者中的研究进展[J]. 实用医院临床杂志, 2024, 21(1):175-178.
	He Y, Cao XH, Lü Q, et al. Research progress of sense of personal mastery in patients with chronic diseases[J]. Pract J Clin Med, 2024, 21(1):175-178.
[4]	张晓敏, 余静丽, 刘彬彬, 等. 2型糖尿病患者健康心理控制源研究进展[J]. 糖尿病新世界, 2022, 25(20):194-198.
	Zhang XM, Yu JL, Liu BB, et al. Progress of research on health psychological control sources for patients with type 2 diabetes[J]. Diabetes New World, 2022, 25(20):194-198.
[5]	张淼, 吴迪, 李明, 等. 主动控制感的测量及认知神经机制[J]. 心理科学进展, 2018, 26(10):1787-1793. doi: 10.3724/SP.J.1042.2018.01787
	Zhang M, Wu D, Li M, et al. The measurement and neural mechanism of sense of agency[J]. Adv Psychol Sci, 2018, 26(10):1787-1793. doi: 10.3724/SP.J.1042.2018.01787
[6]	陈湘军, 邹如意, 刘丽萍, 等. 感知健康能力与婚姻宽恕在农村老年慢性病患者感知伴侣回应性与主动控制感间的链式中介效应[J]. 军事护理, 2025, 42(3):22-26.
	Chen XJ, Zou RY, Liu LP, et al. Chain mediating effect of perceived health competence and marital forgiveness in rural elderly chronic disease patients on perceived partner responsiveness and sense of agency[J]. Mil Nurs, 2025, 42(3):22-26.
[7]	Elsner B, Hommel B. Contiguity and contingency in action-effect learning[J]. Psychol Res, 2004, 68(2/3):138-154.
[8]	Skinner EA. A guide to constructs of control[J]. J Pers Soc Psychol, 1996, 71(3):549-570. pmid: 8831161
[9]	Zautra AJ, Davis MC, Reich JW, et al. Phone-based interven-tions with automated mindfulness and mastery messages im-prove the daily functioning for depressed middle-aged commu-nity residents[J]. J Psychotherapy Integration, 22(3),206-228.
[10]	刘赛赛, 单岩, 高豆青, 等. 慢性病患者感知控制的研究进展[J]. 中华护理教育, 2018, 15(7):541-545.
	Liu SS, Shan Y, Gao DQ, et al. Research progress on percei-ved control of patients with chronic diseases[J]. Chin J Nurs Educ, 2018, 15(7):541-545.
[11]	Zalla T, Sperduti M. The sense of agency in autism spectrum disorders:a dissociation between prospective and retrospective mechanisms?[J]. Front Psychol, 2015,6:1278.
[12]	王红, 单岩, 蒋鑫鑫, 等. 中青年维持性血液透析病人感知控制研究进展[J]. 护理研究, 2021, 35(19):3447-3451.
	Wang H, Shan Y, Jiang XX, et al. Research progress on perception control of maintenance hemodialysis patients in young and middle-aged adults[J]. Chin Nurs Res, 2021, 35(19):3447-3451.
[13]	Tapal A, Oren E, Dar R, et al. The sense of agency scale:a measure of consciously perceived control over one’s mind,body,and the immediate environment[J]. Front Psychol, 2017, 8:1552. doi: 10.3389/fpsyg.2017.01552 pmid: 28955273
[14]	Rossetti I, Musco MA, Sacheli LM, et al. Dissecting sense of agency in schizophrenia:a predictive coding perspective[J]. Schizophr Bull,2025:sbaf054.
[15]	Nobusako S, Ishibashi R, Maeda T, et al. Distorted time win-dow for sensorimotor integration and preserved time window for sense of agency in patients with post-stroke limb apraxia[J]. Front Hum Neurosci, 2025,19:1597200.
[16]	Romeo M, Colle L, Hilviu D, et al. The tangled threads:unvei-ling the interplay between the sense of body ownership and the sense of agency in impacting the bodily-self representa-tion in eating disorders[J]. Cortex, 2025,185:270-285.
[17]	Haggard P, Chambon V. Sense of agency[J]. Curr Biol, 2012, 22(10):R390-R392.
[18]	Frith C. The psychology of volition[J]. Exp Brain Res, 2013, 229(3):289-299. doi: 10.1007/s00221-013-3407-6 pmid: 23354664
[19]	Xu WZ, Legaspi R, Ishikawa Y, et al. Measuring general sense of agency:a Japanese adaptation and validation of the sense of agency scale(J-SoAS)[J]. Front Psychol, 2024,15:1427169.
[20]	Bart VKE, Wenke D, Rieger M. A German translation and validation of the sense of agency scale[J]. Front Psychol, 2023,14:1199648.
[21]	张伯明, 黄冠华, 郑爽, 等. 主动控制感量表中文版的信效度检验[J]. 中国临床心理学杂志, 2022, 30(6):1344-1347,1352.
	Zhang BM, Huang GH, Zheng S, et al. Reliability and validity of the Chinese version of sense of agency scale[J] Chin J Clin Psychol, 2022, 30(6):1344-1347,1352.
[22]	Asai T, Kanayama N, Imaizumi S, et al. Development of embo-died sense of self scale(ESSS):exploring everyday experien-ces induced by anomalous self-representation[J]. Front Psychol, 2016,7:1005.
[23]	Miyawaki Y, Otani T, Yamamoto M, et al. Diminished sense of agency inhibits paretic upper-limb use in patients with post-stroke motor deficits[J]. Cortex, 2024,181:165-178.
[24]	Yang ZJ, Aloe AM, Feeley TH. Risk information seeking and processing model:a meta-analysis[J]. J Commun, 2014, 64(1):20-41.
[25]	Okumura S, Katsuki F. Effective provider communication for personal agency in mental health recovery:a cross-sectional study on Japanese users’ perspectives[J]. J Psychiatr Ment Health Nurs, 2024, 31(6):1164-1174.
[26]	Su GY, Ding JX, Xu Y. Compromised agency in the subjective experiences of temporal distortions among institutionalized Alzheimer’s patients in China:a qualitative study[J]. Qual Health Res,2025:10497323251329764.
[27]	Aromaa E, Eriksson P, Koskinen S. Collaborative autoethno-graphy of cancer patients’ dynamic sense of agency[J]. Qual Health Res, 2025, 35(7):793-806.
[28]	Vogel DHV, Jording M, Weiss PH, et al. Temporal binding and sense of agency in major depression[J]. Front Psychiatry, 2024, 15:1288674.
[29]	Midtgaard J, Stelter R, Rørth M, et al. Regaining a sense of agency and shared self-reliance:the experience of advanced disease cancer patients participating in a multidimensional exercise intervention while undergoing chemotherapy:analysis of patient diaries[J]. Scand J Psychol, 2007, 48(2):181-190. pmid: 17430371
[30]	Awaji A, Fuchigami T, Ogata R, et al. Effects of vibration-based generation of timing of tactile perception on upper limb function after stroke:a case study[J]. Cureus, 2023, 15(12):e50855.
[31]	Cha K, Wang JY, Li Y, et al. A novel upper-limb tracking sys-tem in a virtual environment for stroke rehabilitation[J]. J Neuroeng Rehabil, 2021, 18(1):166.
[32]	Zanchi B, Trevor-Briscoe T, Sarti P, et al. The impact of music therapy in a pediatric oncology setting:an Italian observatio-nal network study[J]. Healthcare, 2024, 12(11):1071.
[33]	Menichetti J, Giusti L, Fossati I, et al. Adjustment to cancer:exploring patients’ experiences of participating in a psycho-dramatic group intervention[J]. Eur J Cancer Care, 2016, 25(5):903-915. doi: 10.1111/ecc.12412 pmid: 26515989
[34]	Powell T, Cohen J, Patterson P. Keeping connected with school:implementing telepresence robots to improve the wellbeing of adolescent cancer patients[J]. Front Psychol, 2021,12:749957.