中国健康心理学杂志

目的：探讨精神分裂症患者生活自理能力与衰弱之间的关系，以及元认知能力与积极心理资源在其中的中介效应。方法：采用便利抽样法，选取2021年4月-2024年12月80例老年精神分裂症患者为研究对象。采用改良Barthel指数量表中文版（MBI-C）、Tilburg衰弱量表（TFI）、元认知问卷（MCQ）及积极心理资源[Snyder希望量表（HHS）与生活定向测试修订版（LOT-R）]进行调查。采用Pearson相关分析探究变量间的关系，采用Bootstrap法检验中介效应。结果：精神分裂症患者生活自理能力总分为42.36±8.92分，衰弱总分为1.73±0.85分，元认知能力总分为68.52±10.96分，希望得分为34.11±4.77分，乐观得分为22.04±3.16分。Pearson相关分析结果显示，生活自理能力与衰弱呈负相关，与元认知能力呈正相关，与希望呈正相关，与乐观呈正相关（r=-0.417,0.362,0.428,0.395;P<0.05）。衰弱与元认知能力、希望、乐观均呈负相关（r=-0.324,-0.397,-0.353;P<0.05）。元认知能力与希望呈正相关，与乐观呈正相关（r=0.302,0.274;P<0.05）。希望与乐观之间呈正相关（r=0.410,P<0.05）。进一步分析显示，元认知能力与积极心理资源在生活自理能力与衰弱中的中介效应分析具有部分中介作用。间接效应分别为-0.126和-0.198，分别占总效应的78.21%和53.77%。结论 ：元认知能力与积极心理资源在精神分裂症患者生活自理能力与衰弱之间发挥重要中介作用，为临床干预提供理论依据。

Objective:To explore the relationship between self-care ability and frailty in patients with schizophrenia,as well as the mediating effects of metacognitive ability and positive psychological resources therein.Methods:Using convenience sampling method,80 elderly patients with schizophrenia were selected as research subjects from April 2021 to December 2024.The Chinese version of the Modified Barthel Index(MBI-C),the Tilburg Frailty Indicator(TFI),the Metacognition Questionnaire(MCQ),and positive psychological resources[including the Snyder Hope Scale(HHS)and the Revised Life Orientation Test(LOT-R)]were used for investigation.Pearson correlation analysis was employed to explore the relationships between variables,and the Bootstrap method was utilized to test the mediating effects.Results:The total score for self-care ability among patients with schizophrenia was(42.36±8.92)points,the total score for frailty was(1.73±0.85)points,the total score for metacognitive ability was(68.52±10.96)points,the score for hope was(34.11±4.77)points,and the score for optimism was(22.04±3.16)points.Pearson correlation analysis revealed that self-care ability was negatively correlated with frailty(r=-0.417,P<0.05),positively correlated with metacognitive ability(r=0.362,P<0.05),positively correlated with hope(r=0.428,P<0.05),and positively correlated with optimism(r=0.395,P<0.05).Frailty was negatively correlated with metacognitive ability,hope,and optimism(r=-0.324,-0.397,-0.353;P<0.05).Metacognitive ability was weakly positively correlated with hope(r=0.302,P<0.05)and weakly positively correlated with optimism(r=0.274,P<0.05).Hope was positively correlated with optimism(r=0.410,P<0.05).Further analysis indicated that metacognitive ability and positive psychological resources had partial mediating effects in the relationship between self-care ability and frailty.The indirect effects were-0.126 and-0.198,accounting for 78.21% and 53.77% of the total effects,respectively.Conclusion:Metacognitive ability and positive psychological resources play significant mediating roles between selfcare ability and frailty in patients with schizophrenia,providing a theoretical basis for clinical interventions.