Analysis of the core and bridge effects of interpersonal, relaxation and medication efficacy in self-management of rheumatoid arthritis patients

DENG Yao; ZHANG Sha; XIANG Xiaorun; WAN Ping; REN Qi; LIU Lei

doi:10.16016/j.2097-0927.202508047

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Analysis of the core and bridge effects of interpersonal, relaxation and medication efficacy in self-management of rheumatoid arthritis patients

Clinical Medicine | 更新时间：2025-12-25

- Analysis of the core and bridge effects of interpersonal, relaxation and medication efficacy in self-management of rheumatoid arthritis patients
- Journal of Army Medical University Vol. 47, Issue 20, Pages: 2532-2539(2025)
- 作者机构：
  
  1.陆军军医大学（第三军医大学）第一附属医院：中医与风湿免疫科，重庆，
  2.陆军军医大学（第三军医大学）第一附属医院：胸外科，重庆，
  3.陆军军医大学（第三军医大学）第一附属医院：心脏外科，重庆，
  4.陆军军医大学（第三军医大学）第一附属医院：院办，重庆，
- 作者简介：
- 基金信息：
  
  the National Natural Science Foundation for Young Scholars of China(82305178);the Joint Traditional Chinese Medicine Scientific Research Project of Chongqing Science and Technology Commission and Chongqing Health Commission(2023QNXM065)
- DOI：10.16016/j.2097-0927.202508047
  CLC： R195.4;R593.22
- Received：18 August 2025，
  
  Revised：2025-10-09，
  
  Accepted：10 October 2025，
  
  Published：30 October 2025
- 稿件说明：
移动端阅览
邓瑶，张沙，向小润，等.人际、放松与药物效能在类风湿关节炎患者自我管理中的核心及桥梁效应分析［J］.陆军军医大学学报，2025，47（20）：2532-2539.DOI：10.16016/j.2097-0927.202508047.

DENG Y，ZHANG S，XIANG X R，et al.Analysis of the core and bridge effects of interpersonal， relaxation and medication efficacy in self-management of rheumatoid arthritis patients［J］.J Army Med Univ，2025，47（20）：2532-2539.DOI：10.16016/j.2097-0927.202508047.
邓瑶，张沙，向小润，等.人际、放松与药物效能在类风湿关节炎患者自我管理中的核心及桥梁效应分析［J］.陆军军医大学学报，2025，47（20）：2532-2539.DOI：10.16016/j.2097-0927.202508047. DOI：

DENG Y，ZHANG S，XIANG X R，et al.Analysis of the core and bridge effects of interpersonal， relaxation and medication efficacy in self-management of rheumatoid arthritis patients［J］.J Army Med Univ，2025，47（20）：2532-2539.DOI：10.16016/j.2097-0927.202508047. DOI：

摘要

目的

探讨类风湿关节炎患者自我效能感各维度间的网络化关联特征，识别核心效能及桥梁效能，为制定精准护理干预策略提供依据。

方法

采用便利抽样法选取2024年9月至2025年1月就诊于陆军军医大学第一附属医院中医与风湿免疫科的652例类风湿关节炎患者，使用一般资料调查表和类风湿关节炎自我效能感量表（Rheumatoid Arthritis Self-Efficacy Scale，RASE）进行评估。通过探索性因子分析提取效能症状群，运用R语言软件，选择症状网络分析方法构建效能维度间的关联网络，计算中心性指标（强度、紧密度、中介度）以识别核心及桥梁效能。

结果

探索性因子分析提取7个效能症状群，累积方差贡献率64.539%（

0.001）。网络分析显示，网络密度为0.143，提示各效能维度间存在中等关联性，“放松效能1（r1）”和“疼痛效能1（a1）”相关性最强（

=0.73）。“人际效能2（i2）”的强度中心性（6.88）最高，“放松效能3（r3）”的紧密度（0.0125）和“药物效能1（m1）”的中介度（116）最高，是该网络群中的核心效能和桥梁效能。

结论

类风湿关节炎患者自我效能感各维度间存在复杂的网络化关联，人际效能是核心驱动因素，放松与药物效能发挥桥梁作用，共同影响患者整体自我管理能力水平。

Abstract

Objective

To explore the networked association among the dimensions of self-efficacy in patients with rheumatoid arthritis (RA) and to identify core efficacy and bridge efficacy

and provide a basis for formulating precise nursing intervention strategies.

Methods

A total of 652 RA patients admitted in our hospital from September 2024 to January 2025 were enrolled with convenience sampling. The general information questionnaire and Rheumatoid Arthritis Self-Efficacy Scale (RASE) were used for assessment. Exploratory factor analysis was used to extract efficacy symptom clusters. With aid of R project

network analysis was employed to construct an association network among efficacy dimensions to calculate centrality indicators (strength

closeness

betweenness) to identify core efficacy and bridge efficacy.

Results

Exploratory factor analysis extracted 7 efficacy symptom clusters

with a cumulative variance contribution rate of 64.539% (

0.001). Network analysis showed that the network density was 0.143

suggesting that there were moderate correlations among the self-efficacy dimensions. “Relaxation efficacy 1 (r1)” and “pain efficacy 1 (a1)

” had the strongest correlation (

=0.73). Interpersonal efficacy 2 (i2) had the highest intensity centrality (6.88)

and relaxation efficacy 3 (r3) had the highest tightness (0.0125)

and medication efficacy 1 (m1) had the highest mediation (116)

which were the core efficacy and bridge efficacy in this network group.

Conclusion

There are complex network-like correlations among the various dimensions of self-efficacy in RA patients. Interpersonal efficacy is the core driving factor

while relaxation and medication efficacies play the bridging role

jointly influencing the overall level of patients’ self-management ability.

关键词

Keywords

references

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陆军军医大学(第三军医大学)：第一附属医院中西医结合科，第一附属医院全军感染病研究所，基础医学院实验动物学教研室

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