Whitmarsh Anya, Koutantji Maria, Sidell Kate
Clinical Health Psychology, Torbay Hospital, Lawes Bridge, UK.
Br J Health Psychol. 2003 May;8(Pt 2):209-21. doi: 10.1348/135910703321649178.
The aim of this study was to identify psychological variables in poor/non-attendance at cardiac rehabilitation (CR). We investigated whether attenders and poor/non-attenders differed in relation to components of the self-regulatory model and coping, and which of these variables were the best predictors of attendance behaviour.
A cross-sectional, between groups design was employed. In contrast with two previous similar studies, participants completed self-report measures shortly before the start date for the CR programme. Univariate and logistic regression analyses were conducted.
In all, 93 individuals who had been invited to attend CR completed the Illness Perceptions Questionnaire (IPQ), the Hospital Anxiety and Depression Scale (HADS) and the Coping Orientation to Problems Experienced (COPE). Subsequently, 32 participants failed to attend, or dropped out early from, the programme.
Attenders differed from poor/non-attenders in that they perceived a greater number of symptoms and consequences of their illness, greater distress, less strong beliefs that their illness had been caused by a germ or virus, and used problem-focused and emotion-focused coping more frequently. The best predictors of poor/non-attendance were lower perceptions of symptoms and controllability/curability of illness, and less frequent use of problem-focused and more frequent use of maladaptive coping strategies.
Attenders and poor/non-attenders at CR were distinguished by illness representations, distress and usage of coping strategies. The variables found to be the best predictors of attendance could be used to screen those unlikely to attend and to develop interventions for enhancing attendance.
本研究旨在确定心脏康复(CR)参与度低/未参与的心理变量。我们调查了参与者与参与度低/未参与者在自我调节模型和应对方式的组成部分上是否存在差异,以及这些变量中哪些是参与行为的最佳预测指标。
采用横断面组间设计。与之前两项类似研究不同的是,参与者在CR计划开始日期前不久完成了自我报告测量。进行了单变量和逻辑回归分析。
共有93名被邀请参加CR的个体完成了疾病认知问卷(IPQ)、医院焦虑抑郁量表(HADS)和应对问题经历的应对方式(COPE)。随后,32名参与者未参加或提前退出了该计划。
参与者与参与度低/未参与者的不同之处在于,他们感知到的疾病症状和后果更多,痛苦程度更高,认为疾病由细菌或病毒引起的信念不那么强烈,并且更频繁地使用以问题为中心和以情绪为中心的应对方式。参与度低/未参与的最佳预测指标是对症状的感知较低、对疾病的可控性/可治愈性较低,以及较少使用以问题为中心的应对方式和更频繁地使用适应不良的应对策略。
CR的参与者和参与度低/未参与者在疾病表征、痛苦程度和应对策略的使用方面存在差异。被发现是参与度最佳预测指标的变量可用于筛选那些不太可能参与的人,并制定提高参与度的干预措施。