Wöller W, Kruse J, Arnolds S, Kraut D, Richter B, Worth H
Klinisches Institut und Klinik für Psychosomatische Medizin und Psychotherapie, Heinrich-Heine-Universität Düsseldorf.
Pneumologie. 1992 Aug;46(8):326-9.
Patients with bronchial asthma often exhibit irrational fears of cortisone medication beyond justified worries about side-effects. A negative cortisone image, which means overemphasizing the damaging and threatening aspects of cortisone, often underlies non-compliant illness behaviour. In the present study, cortisone image was investigated in 54 patients with bronchial asthma before and after participation in the Düsseldorf Asthma treatment and teaching programme (ATTP) and one year later. By participating in ATTP, a significant reduction of the negative cortisone image and thus a more realistic view of cortisone could be achieved in most patients. This effect was also evident at the follow-up examination one year later. On the other hand, persistence of a negative cortisone image in a subgroup of patients turned out to be a potent predictor of later non-compliant illness behaviour. Psychological implications of a persistent negative cortisone image are discussed.
支气管哮喘患者常常对皮质醇药物表现出不合理的恐惧，超出了对副作用的合理担忧。负面的皮质醇形象，即过度强调皮质醇的损害性和威胁性方面，往往是不遵医嘱行为的潜在原因。在本研究中，对54名支气管哮喘患者在参加杜塞尔多夫哮喘治疗与教学项目（ATTP）之前、之后以及一年后对皮质醇的认知形象进行了调查。通过参加ATTP，大多数患者的负面皮质醇形象显著降低，从而对皮质醇有了更现实的看法。这种效果在一年后的随访检查中也很明显。另一方面，在一部分患者中持续存在的负面皮质醇形象被证明是后来不遵医嘱行为的有力预测指标。文中讨论了持续存在负面皮质醇形象的心理影响。
