Fortune D G, Richards H L, Main C J, Griffiths C E M
Dermatology Centre, University of Manchester School of Medicine, Hope Hospital, Salford, UK.
Clin Exp Dermatol. 2002 May;27(3):177-84. doi: 10.1046/j.1365-2230.2002.01055.x.
There is a paucity of research on the types of strategies that patients with psoriasis use to cope with the impact of their condition. By contrast there are a number of studies assessing coping by patients with nondermatological disease. The purpose of the present study was to examine strategies for coping in patients with psoriasis and investigate whether they differ as compared with normal controls and patients with other major medical diseases. Two hundred and fifty patients with a definite dermatologist-confirmed diagnosis of psoriasis participated in this cross-sectional study. Patients were assessed by psoriasis area severity index and all patients completed the COPE questionnaire and psoriasis disability index. Sixty healthy, control participants completed the COPE questionnaire for comparison purposes. Mean COPE scores from patients with psoriasis were also compared with published COPE scores from other medical diseases. The coping strategies most frequently used by patients with psoriasis were acceptance, planning, active coping and positive reinterpretation. The least frequently used were alcohol and nonprescription drugs, religion, and denial of their condition. Despite reporting greater disability, patients with severe psoriasis did not significantly differ from those with mild/moderate disease in their use of particular forms of coping strategies. Patients with psoriasis as a whole tended to use significantly less active coping strategies, planning, positive reinterpretation and humour when compared with normal controls. There was marked similarity in the frequency of use of particular coping strategies between patients with psoriasis and patients with other medical conditions. Similar types of coping strategies are utilized by patients regardless of whether their illness is visible (psoriasis) invisible (chronic fatigue syndrome, atrial fibrillation), has significant physical impairment (spinal cord injury), or is life-threatening (cancer, and myocardial infarction). It appears that illness brings with it a generic form of coping that may require shaping to fit the individual demands of diseases such as psoriasis.
关于银屑病患者用以应对病情影响的策略类型，相关研究较少。相比之下，有许多研究评估非皮肤病患者的应对方式。本研究的目的是考察银屑病患者的应对策略，并调查这些策略与正常对照组以及其他重大疾病患者相比是否存在差异。250名经皮肤科医生确诊为银屑病的患者参与了这项横断面研究。通过银屑病面积和严重程度指数对患者进行评估，所有患者均完成了应对方式问卷（COPE）和银屑病残疾指数评估。60名健康对照参与者完成了应对方式问卷以作比较。还将银屑病患者的平均应对方式问卷得分与其他疾病已发表的应对方式问卷得分进行了比较。银屑病患者最常使用的应对策略是接受、计划、积极应对和积极重新诠释。最少使用的是酒精和非处方药、宗教以及否认自身病情。尽管重度银屑病患者报告的残疾程度更高，但在特定应对策略的使用上，他们与轻度/中度银屑病患者并无显著差异。总体而言，与正常对照组相比，银屑病患者倾向于显著较少地使用积极应对策略、计划、积极重新诠释和幽默。银屑病患者与其他疾病患者在特定应对策略的使用频率上存在明显相似性。无论疾病是可见的（银屑病）、不可见的（慢性疲劳综合征、心房颤动）、有显著身体损伤的（脊髓损伤）还是危及生命的（癌症、心肌梗死），患者都使用相似类型的应对策略。似乎疾病带来了一种通用的应对方式，可能需要根据银屑病等疾病的个体需求进行调整。
