目的 探讨大一护理系学生（护生）心理健康素养、心理健康与心理弹性的现状以及三者之间的关系。方法 采用方便抽样法选取大一护生202人作为研究对象,采用一般资料问卷、青少年心理健康素养评定量表（AMHLAQ）、心理健康量表（K10）,心理弹性量表（CD-RISC）进行调查。结果 （1）城市大一护生心理健康素养（t=-2.832,P<0.01）、心理健康水平（t=3.052,P<0.001）和心理弹性水平（t=-2.521,P<0.05）高于农村大一护生;独生子女的心理健康素养（t=2.098,P<0.05）和心理健康水平（t=-2.684,P<0.01）高于非独生;父亲学历为高中及以上的心理健康素养（t=-2.543,P<0.05）和心理健康水平（t=3.082,P<0.01）高于父亲学历为初中及以下;母亲学历为高中及以上的心理健康素养（t=-2.052,P<0.05）和心理健康水平（t=2.595,P<0.01）高于父亲学历为初中及以下;（2）心理健康得分越高,心理问题越严重,心理健康素养与心理弹性呈正相关（r=0.340,P<0.01）,心理健康得分与心理健康素养、心理弹性呈负相关（r=-0.651,-0.384,P<0.01）。（3）心理弹性在心理健康素养与心理健康中存在部分中介效应,中介效应值为-0.190,中介效应占比15.68%。结论 山西医科大学汾阳学院大一护生心理健康存在一定问题,要多注重农村地区、非独生子女以及父母学历较低的人群心理健康和心理健康素养的培养,大一护生心理健康素养越高,心理弹性水平越高,心理健康得分越低,心理健康水平越高。心理弹性在心理健康素养与心理健康中起中介作用,可以提升大一护生的心理弹性水平,培养其坚韧性、自强性和乐观性,从而降低心理健康得分,提高心理健康水平。

Objective To explore the current status of mental health literacy,mental health,and psychological resilience among first-year nursing students,as well as the relationship among the three．Methods A total of 202 freshmen were selected as the research subjects using convenience sampling method．The survey was conducted using a general information questionnaire,the Adolescent Mental Health Literacy Assessment Scale（AMHLAQ）,the Mental Health Scale（K10）,and the Psychological Resilience Scale（CD-RISC）．Results （1）The mental health literacy（t=-2.832,P<0.01）,mental health level（t=3.052,P<0.001）,and psychological resilience level（t=-2.521,P<0.05）of urban freshmen were significantly higher than those of rural freshmen．The mental health literacy（t=2.098,P<0.05）and mental health level（t=-2.684,P<0.01）of only-child were higher than those of non-only-child．The mental health literacy（t=-2.543,P<0.05）and mental health level（t=3.082,P<0.01）of the father with a high school education or above were higher than those of the father with a middle school education or below．The mental health literacy（t=-2.052,P<0.05）and mental health level（t=2.595,P<0.01）of the mother with a high school education or above were higher than those of the father with a middle school education or below．（2）The higher the mental health score,the more serious the psychological problem．There was a significant positive correlation between mental health literacy and psychological resilience（r=0.340,P<0.01）,while there was a significant negative correlation among mental health score and mental health literacy and psychological resilience（r=-0.651,-0.384,P<0.01）．（3）Psychological resilience had a partial mediating effect between mental health literacy and mental health,with a mediating effect value of -0.190,accounting for 15.68% of the total．Conclusions There are certain problems with the mental health of freshmen nursing students in Shanxi Medical University．It is necessary to pay more attention to the cultivation of mental health and mental health literacy in rural areas,non-only-child,and those whose parents with lower educational level．The higher the mental health literacy and resilience level of freshmen nursing students,the lower their mental health scores,and the higher their mental health level．Psychological resilience plays a mediating role in the relationship between mental health literacy and mental health．It can cultivate the level of psychological resilience,resilience,self-improvement and optimism of first-year nursing students,thereby reducing their mental health scores and improving their mental health level．

目的 探讨院外延续性护理联合院内心理指导对重症烧伤患者创伤应激的影响。方法 选取2020年6月—2022年6月南开大学附属医院（天津市第四医院）重症烧伤科收治的86例重度烧伤患者为研究对象,应用随机数字表法将患者分为观察组与对照组,每组各43例。对照组采取常规护理,观察组在常规护理基础上增加院外延续性护理联合院内心理指导,评估患者的创伤应激指标[血清肿瘤坏死因子α（TNF-α）、白细胞介素6（IL-6）、β-内啡肽（β-ep）]、心理韧性程度、应对行为、创伤后成长水平,并分析患者创伤应激与心理韧性的相关性。结果 干预前,两组的TNF-α、IL-6、β-ep水平比较差异无统计学意义（P>0.05）;干预后,两组创伤应激相关指标水平均下降,且观察组降低幅度更大（P<0.05）。干预后,两组患者乐观性、力量性、坚韧性相关中文版创伤后成长评定量表（C-PTGI）评分均升高,且观察组更高（P<0.05）;Pearson相关性分析显示,TNF-α、IL-6、β-ep等创伤应激指标水平与心理韧性水平呈负相关（P<0.05）;干预后,两组患者积极应对特质应对方式问卷（TCSQ）评分均升高,观察组高于对照组,人消极应对评分均降低,观察组低于对照组（P<0.05）;干预后,两组患者人际关系、精神变化、生活欣赏、个人力量、新的可能相关C-PTGI评分分量表得分均升高,观察组高于对照组（P<0.05）。结论 对重度烧伤患者采取院外延续性护理联合院内心理指导能够降低患者的创伤后应激水平、消极应对评分,提升患者心理韧性程度、创伤后成长水平以及积极应对评分,且创伤后应激水平与心理韧性水平呈负相关。

Objective To explore the effect of out-hospital continuous nursing combined with in-hospital psychological guidance on traumatic stress in severe burn patients．Methods A total of 86 patients with severe burn treated in the Affiliated Hospital of Nankai University（Tianjin Fourth Hospital）from June 2020 to June 2022 were selected as the research objects．The patients were divided into observation group and control group by random number table method,with 43 cases in each group．The control group received routine care,and the observation group was supplemented with out-hospital continuous nursing and in-hospital psychological guidance on the basis of routine care．The traumatic stress indexes [serum tumor necrosis factor-α（TNF-α）,interleukin-6（IL-6）,β-endorphin（β-ep）],psychological toughness,coping behavior and post-traumatic growth level of the patients were evaluated．The correlation between traumatic stress and mental toughness was analyzed．Results Before intervention,the levels of TNF-α,IL-6 and β-ep were not significantly different between the two groups（P>0.05）．After intervention,the levels of traumatic stress-related indicators were decreased between the two groups,and the reduction was greater in the observation group（P<0.05）．After intervention,C-PTGI scores related to optimism,strength and fortitude were increased in both groups,which were higher in observation group（P<0.05）．Pearson correlation analysis showed that the levels of TNF-α,IL-6,β-ep and other traumatic stress indexes were significantly negatively correlated with the levels of mental toughness（P<0.05）．After intervention,the positive coping TCSQ scores of both groups were increased,the observation group was higher,and the negative coping scores were decreased,while the observation group was lower（P<0.05）．After the intervention,the scores of interpersonal relationships,mental changes,life appreciation,personal strength,and new possibly relevant C-PTGI score subscale were increased in both groups,and higher in the observation group（P<0.05）．Conclusions The combination of out-hospital continuous nursing and in-hospital psychological guidance for severe burn patients can reduce the level of post-traumatic stress and negative response score of patients,and improve the level of mental toughness,post-traumatic growth and positive score of patients,and the level of post-traumatic stress is significantly negatively correlated with the level of mental toughness．