| Objective:Gastroscopy is a common test for the diagnosis of gastrointestinal diseases,but because gastroscopy operations are invasive,many patients still have some misconceptions about gastroscopy and are reluctant to undergo gastroscopy,so that they miss the opportunity for early detection and early treatment of diseases.At present,studies on the factors influencing patients’anxiety before gastroscopy are inconsistent.Finding factors that influence patients’pre-gastroscopy anxiety and conducting targeted interventions to reduce pre-gastroscopy anxiety are essential to promote gastroscopy screening behavior and improve the tolerance of gastroscopy.The purpose of this study was to investigate the level of anxiety in pre-gastroscopy patients,analyze its influencing factors,and introduce positive psychology concepts(positive coping style and psychological resilience)into the study of pre-gastroscopy patient anxiety,analyze the strength of the association between positive coping style and psychological resilience and pre-gastroscopy patient anxiety,explore the role of positive coping style and psychological resilience in comprehending the relationship between social support and pre-gastroscopy patient anxiety To explore the mechanism of the role of positive coping and psychological resilience in understanding the relationship between social support and patient anxiety before gastroscopy,to provide basic theoretical support for positive psychological intervention,to help find reasonable measures to alleviate patient anxiety before gastroscopy,and to promote the smooth performance of gastroscopy.Methods:In this study,a convenience sampling method was used to collect patients waiting for gastroscopy in a tertiary hospital in Shenyang from October 2021 to February2022,and a self-administered gastroscopy-related questionnaire and a self-statement questionnaire consisting of the State Anxiety Scale,the Self-Rated Health Status,the Brief Coping Style Scale,the Brief Version Psychological Flexibility Scale,and the Appreciative Social Support Scale were used to collect indicators of individual characteristics,examination-related conditions,preoperative concerns,and psychosocial factors of patients undergoing gastroscopy.In this study,Epidata 3.1 software was used to enter the data,and SPSS 22.0 and AMOS 21.0 were used to analyze the data and construct structural equation models.In this first,t-test and one-way ANOVA were used to analyze the factors influencing patient anxiety before gastroscopy,and stratified regression analysis was used to test whether there was a significant effect of perceived social support,positive coping style,and psychological resilience on patient anxiety.Second,AMOS 21.0 was used to test the mediating role of positive coping style and psychological resilience between perceived social support and anxiety through structural equation modeling based on the hypothesis and the results of the stratified regression analysis.Model fitting was estimated using the maximum likelihood method(ML),and indicators such as~2∕(9,TLI,CFI,and RMSEA were selected to evaluate the degree of model fit.Bootstrap method was used to test the significance of the path effect values,and the effect was considered significant if the 95%confidence interval of the effect value did not contain 0.The invariance of the model across gender groups and with and without anesthesia groups was also tested by multi-cluster analysis.Results:Anxiety symptoms were at a high level in patients before gastroscopy,with 75%of patients having moderate or higher levels of anxiety symptoms.In this study,there was no significant difference in the total score of state anxiety between male patients and the norm(=1.86,>0.05),but the total score of state anxiety in female patients was significantly higher than that in the norm(=8.84,<0.01).The state anxiety of male patients was significantly lower than that of female patients(=-3.857,<0.01).The main factors influencing patient anxiety before gastroscopy were:gender,self-rated health status,knowledge related to gastroscopy,type of gastroscopy,fear of gastroscopy,concern about diagnostic results,concern about sterilization of examination instruments,and concern about gastroscopy safety.Patients’psychological resilience score,positive coping style score,total perceived social support score and its three sub-dimensions were significantly and negatively correlated with pre-gastroscopy anxiety(<0.01).Positive coping and psychological resilience mediated the relationship between perceived social support and pre-gastroscopy patient anxiety,with the total indirect effect accounting for 90.85%of the total effect of perceived social support on anxiety.Perceived social support could not directly predict patients’anxiety before gastroscopy through positive coping style or psychological resilience,and their indirect effects accounted for 30.86%and 31.71%of the total effect,respectively,while perceived social support could indirectly act on anxiety through the chain mediating effect of positive coping style and psychological resilience,and this chain mediating effect accounted for 28.28%of the total effect.A multicluster test showed that this chain mediated effect model had some invariance across gender cohorts and groups with or without anesthesia.Conclusion:The anxiety symptoms of patients before gastrointestinal endoscopy were at a high level,and 75%of the patients had moderate and above anxiety symptoms.The main factors affecting the anxiety of patients before gastrointestinal endoscopy are:gender,self-assessed health status,knowledge about gastrointestinal endoscopy,type of gastrointestinal endoscopy,fear of gastrointestinal endoscopy,worry about diagnosis results,and worry about disinfection of examination equipment Situations and concerns about the safety of gastrointestinal endoscopy.Anxiety before gastrointestinal endoscopy was significantly negatively correlated with resilience score,positive coping style score,total score of perceived social support and its three sub-dimensions.Positive coping style and psychological resilience play a chain mediating role between perceived social support and patient anxiety before gastroenteroscopy.That is,the perceived social support mainly affects the anxiety of patients before gastrointestinal endoscopy indirectly through positive coping style or psychological resilience,and can also indirectly affect the anxiety of patients before gastrointestinal endoscopy through the chain mediation effect of positive coping style and psychological resilience. |
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