Scharloo M, Kaptein A A, Weinman J A, Hazes J M, Breedveld F C, Rooijmans H G
Leiden University Medical Center, The Netherlands.
J Rheumatol. 1999 Aug;26(8):1686-93.
To determine whether coping strategies and illness perceptions would be predictive of outcome in a longitudinal study of patients with rheumatoid arthritis (RA).
A group of 71 patients with RA was examined on 2 occasions, one year apart. Multiple regressions were used to examine which of the illness perceptions and coping strategies explained variance on the outcome variables: visits to the outpatient clinic, number of hospital admissions, Health Assessment Questionnaire, pain, tiredness, the Hospital Anxiety and Depression Scale.
Belief in adverse consequences of the disease was associated with more visits to the outpatient clinic. more tiredness, and higher anxiety scores. Less perceived control and less expression of emotion were associated with more hospital admissions. High scores on coping involving fostering reassuring thoughts were associated with more functional disability. More passive coping was associated with more functional disability and higher anxiety scores. More perceived symptoms were associated with more pain, more tiredness, and more depression. More avoidant coping was associated with more tiredness. Belief that the illness will last a long time was associated with higher anxiety scores.
Our longitudinal data show that, after statistically controlling for the potential effects of intervening medical variables, coping strategies and illness perceptions contribute to health outcome in patients with RA. Implications for patient management are discussed.
在一项针对类风湿关节炎（RA）患者的纵向研究中，确定应对策略和疾病认知是否能预测结果。
对71名RA患者进行了两次检查，间隔一年。使用多元回归分析来检验哪些疾病认知和应对策略能够解释结果变量的差异，这些结果变量包括：门诊就诊次数、住院次数、健康评估问卷、疼痛、疲劳程度以及医院焦虑抑郁量表得分。
对疾病不良后果的信念与更多的门诊就诊次数、更多的疲劳感以及更高的焦虑得分相关。较低的感知控制感和较少的情绪表达与更多的住院次数相关。在涉及培养安心想法的应对方式上得分较高与更多的功能残疾相关。更多的消极应对与更多的功能残疾和更高的焦虑得分相关。更多的感知症状与更多的疼痛、更多的疲劳感以及更多的抑郁相关。更多的回避应对与更多的疲劳感相关。认为疾病会持续很长时间的信念与更高的焦虑得分相关。
我们的纵向数据表明，在对干预性医学变量的潜在影响进行统计学控制后，应对策略和疾病认知对RA患者的健康结果有影响。文中还讨论了对患者管理的启示。
