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银屑病患者的疾病认知与应对方式对功能状态的预测作用:一项为期1年的随访研究

Patients' illness perceptions and coping as predictors of functional status in psoriasis: a 1-year follow-up.

作者信息

Scharloo M, Kaptein A A, Weinman J, Bergman W, Vermeer B J, Rooijmans H G

机构信息

Medical Psychology, Department of Psychiatry, Leiden University Medical Centre, Leiden, PO Box 1251, 2340 BG Oegstgeest, The Netherlands.

出版信息

Br J Dermatol. 2000 May;142(5):899-907. doi: 10.1046/j.1365-2133.2000.03469.x.

Abstract

In a longitudinal study (two measurements with a 1-year interval), 69 patients with psoriasis completed the Illness Perception Questionnaire, the Medical Outcomes Study SF-20 Health Survey, and the Hospital Anxiety and Depression Scale. Data on coping (Utrecht Coping List) and severity of illness (body surface scores) were also collected. The results of regression analyses indicated that a strong illness identity was associated with more visits to the outpatient clinic, and worse outcome on physical health, social functioning, mental health, health perceptions and depression. Strong beliefs that the disease is controllable/curable and that the disease has disabling consequences were also related to more clinic visits and more negative perceived health, respectively. Patients who initially engaged in coping characterized by more expression of emotions, seeking more social support, seeking more distraction, and less passive coping were prescribed a lower number of different therapies, were less anxious, less depressed, and had a better physical health 1 year later. These results have implications for the management of patients with psoriasis, which reinforces current views on integrating psychosocial aspects into clinical care.

摘要

在一项纵向研究(间隔1年进行两次测量)中,69名银屑病患者完成了疾病认知问卷、医学结局研究SF - 20健康调查以及医院焦虑抑郁量表。还收集了应对方式(乌得勒支应对清单)和疾病严重程度(体表面积评分)的数据。回归分析结果表明,强烈的疾病认同与更多次门诊就诊以及身体健康、社会功能、心理健康、健康认知和抑郁方面更差的结果相关。认为疾病可控/可治愈的强烈信念以及认为疾病会导致残疾的信念,分别也与更多次门诊就诊和更负面的健康认知相关。最初采用更多情绪表达、寻求更多社会支持、寻求更多分心方式以及较少消极应对方式来应对的患者,1年后所接受的不同治疗种类较少,焦虑程度较低,抑郁程度较低,身体健康状况较好。这些结果对银屑病患者的管理具有启示意义,强化了当前将心理社会因素纳入临床护理的观点。

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