【摘要】 目的 探讨自我效能在类风湿关节炎患者社会支持与经验性回避之间的中介作用。方法 本研究选取2020年11月—2021年1月在青岛市某三级甲等综合医院风湿免疫科就诊的204例类风湿关节炎患者为研究对象，采用社会支持评定量表、中文版关节炎自我效能感量表、接纳与行动问卷进行现场调查。结果 类风湿关节炎患者经验性回避、社会支持、自我效能得分分别为（28.59±10.02）分、（35.49±7.35）分、（6.25±1.64）分；社会支持与经验性回避呈负相关（r=-0.316,P<0.001），自我效能与经验性回避呈负相关（r=-0.554, P<0.001）；社会支持对经验性回避的总效应为-0.316(95%CI=-0.448～-0.185,P<0.001)，直接效应为-0.156(95%CI=-0.276～-0.036, P=0.011)，间接效应为-0.160(95%CI=-0.247～-0.085)，中介效应占比50.6%。结论 类风湿关节炎患者经验性回避水平较高，社会支持水平较低，社会支持情况和自我效能均是经验性回避水平的负向预测因子。社会支持可以通过自我效能间接影响经验性回避，提示医务工作者可以通过加强患者的社会支持情况，提高患者的自我效能，以降低类风湿关节炎患者的经验性回避水平。更多还原

【Abstract】 Objective To explore the mediating effect of self-efficacy between social support and experiential avoidance in patients with rheumatoid arthritis(RA). Methods From November 2020 to January 2021, 204 RA outpatients from a tertiary grade-A general hospital in Qingdao were selected as the subjects. The investigation was performed by using Social Support Rating Scale(SSRS),Arthritis Self-Efficacy Scale-8(ASES-8) and Acceptance and Action Questionnaire-2 nd Edition(AAQ-Ⅱ). Results The score of experiential avoidance, social support and self-efficacy in RA patients was 28.59 ±10.02, 35.49±7.35 and 6.25±1.64 respectively.Social support was negatively correlated with experiential avoidance(r=-0.316, P<0.001), and self-efficacy was negatively correlated with experiential avoidance(r=-0.554,P<0.001).The total effect of social support on experiential avoidance was-0.316(95%CI=-0.448～-0.185,P<0.001); the direct effect-0.156(95%CI=-0.276～-0.036, P=0.011); the indirect effect-0.160(95%CI=-0.247～-0.085), and the mediating effect accounted for 50.6%. Conclusion The level of experiential avoidance in RA patients is high while that of social support low. Social support and self-efficacy are both negative predictors of experiential avoidance. Social support can indirectly affect experiential avoidance through self-efficacy, suggesting that self-efficacy could be improved by more social support, so as to reduce the level of experiential avoidance in RA patients.更多还原