廖晓红 吴金华 曾秋萍 何燕妃 汪林芳

【摘要】 目的：探讨自我接纳在勃起功能障碍（ED）患者病耻感与抑郁症状间的中介作用。方法：采用便利抽样法选取2022年1—12月于赣州市人民医院就诊的76例ED患者为研究对象，选取80例健康者作为健康组。使用一般资料调查表、自我接纳问卷（SAQ）、社会影响量表（SIS）和患者健康问卷（PHQ-9）调查评估研究对象自我接纳程度、病耻感程度、抑郁症状程度。并用采用分层回归法分析、检验患者自我接纳、病耻感与抑郁症状程度之间的关系和中介效应。结果：本次调查的ED患者SAQ总分（37.04±6.50）分，SIS總分（56.04±6.56）分，PHQ-9总分（8.53±2.98）分；ED组SAQ总分显著低于健康组，SIS总分和PHQ-9总分均显著高于健康组，差异均有统计学意义（P<0.05）。Pearson检验显示， ED患者自我接纳程度与病耻感程度、抑郁症状严重程度均为负相关（P<0.05），病耻感程度与抑郁症状严重程度为正相关（P<0.05）；中介效应检验显示，ED患者的自我接纳在患者病耻感与抑郁症状严重程度间起部分中介作用，占总效应的14.95%。结论：ED患者病耻感通过自我接纳的中介作用影响抑郁症状严重程度。

【关键词】 勃起功能障碍 自我接纳 病耻感 抑郁 中介作用

The Mediating Effect of Self Acceptance between Stigma and Depressive Symptoms in Patients with Erectile Dysfunction/LIAO Xiaohong， WU Jinhua， ZENG Qiuping， HE Yanfei， WANG Linfang. //Medical Innovation of China， 2024， 21（08）： -151

[Abstract] Objective： To explore the mediating effect of self acceptance between stigma and depressive symptoms in patients with erectile dysfunction （ED）. Method： A total of 76 patients with ED treated in Ganzhou People's Hospital from January to December 2022 were selected as the study objects according to convenience sampling method， 80 healthy subjects were selected as the healthy group. The general information questionnaire， self acceptance questionnaire （SAQ）， social impact scale （SIS） and patient health questionnaire-9 （PHQ-9） were used to investigate and evaluate the degree of self acceptance， stigma and depressive symptoms of the subjects. Hierarchical regression method was used to analyze and examine the relationship and mediating effect between self acceptance， stigma and the degree of depressive symptoms. Result： The total score of SAQ， SIS and PHQ-9 in ED patients respectively was （37.04±6.50） scores， （56.04±6.56） scores and （8.53±2.98） scores. The total score of SAQ in ED group was significantly lower than those in healthy group， and the total score of SIS and PHQ-9 in ED group were significantly higher than those in healthy group， the differences were statistically significant （P<0.05）. Pearson test showed that the degree of self acceptance was negatively correlated with the degree of stigma and the severity of depressive symptoms in ED patients （P<0.05）， and the degree of stigma was positively correlated with the severity of depressive symptoms （P<0.05）. The mediating effect test showed that the self acceptance of ED patients played a partial mediating effect in the relationship between stigma and the severity of depressive symptoms， accounting for 14.95% of the total effect. Conclusion： The stigma of ED patients influences the severity of depressive symptoms through the mediating effect of self acceptance.

[Key words] Erectile dysfunction Self acceptance Stigma Depression Mediating effect

First-author's address： Department of Male Medicine， Ganzhou People's Hospital， Ganzhou 341000， China

doi：10.3969/j.issn.1674-4985.2024.08.033

勃起功能障礙（erectile dysfunction，ED）是男科常见的性功能障碍，是指男性长期无法实现持续或维持阴茎勃起，导致无法获得满意的性生活[1]。全球近1.5亿成年人患ED，国内调查显示ED发病率为25.8%～39.1%，40岁以上男性ED患病率更高，高达40.6%[2]。目前认为ED与年龄、冠状动脉疾病、肥胖、糖尿病、抑郁、高血压及不良生活方式等因素有关，常规治疗措施包括生活方式管理、干预危险因素、口服磷酸二酯酶5（PDE5）抑制剂、心理疏导等[3]。既往研究主要关注药物治疗效果及对危险因素的探索，对患者心理状况的研究较少，而ED会严重影响患者的心理健康。据报道，ED患者的负性情绪检出率高，63.1%的ED患者可能产生精神症状，其中抑郁是ED患者最常见的伴随症状[4]。由于ED严重影响患者的个人、社交和性生活，造成患者心理负担，容易产生病耻感，而病耻感与抑郁症状之间存在正相关，降低病耻感，有助于提高患者治疗依从性和效果，减轻抑郁症状[5-6]。……