Sharpe Louise, Curran Leah
School of Psychology, Clinical Psychology Unit F12, The University of Sydney, Sydney, NSW 2006, Australia.
Soc Sci Med. 2006 Mar;62(5):1153-66. doi: 10.1016/j.socscimed.2005.07.010. Epub 2005 Aug 22.
This article examines the literature relating to adjustment to physical illness. Adjustment is invariably defined in the literature as some aspect of psychological function. However, in reality, adjustment is a process that begins at the presentation of symptoms and continues throughout the course of the illness and responds to changes in illness status. Physical illness can be conceptualized as a stressor, the demands of which depend upon the characteristics and severity of the illness. Recent research confirms that many of the factors known to be associated with the development of psychological disorders in the absence of physical illness are also relevant to the development of psychological problems in those with ill health. The prevalence of psychological disorders is also generally found to be considerably higher amongst those with a variety of health problems. Nonetheless, a considerable number of patients who experience even the most devastating of illnesses seem able to adjust to illness without experiencing clinically significant psychological problems. The processes by which these people are able to adjust and, in many cases, find positive meaning in their experiences, are important to understand. While a number of models have been put forward to explain various aspects of adjustment to chronic illness, an integrated approach that describes how the process of adjustment evolves is needed. Such an understanding will allow clinicians to improve interventions that facilitate adjustment and potentially prevent long-term problems. Facilitating a patient's adjustment to illness must be a priority in providing an optimal level of health care.
本文探讨了与适应身体疾病相关的文献。在文献中,适应总是被定义为心理功能的某个方面。然而,实际上,适应是一个从症状出现开始,贯穿疾病全过程,并对疾病状态变化做出反应的过程。身体疾病可以被概念化为一种应激源,其要求取决于疾病的特征和严重程度。最近的研究证实,许多在没有身体疾病时已知与心理障碍发展相关的因素,在健康状况不佳的人群中也与心理问题的发展相关。在患有各种健康问题的人群中,心理障碍的患病率通常也被发现要高得多。尽管如此,相当多的患者即使经历了最严重的疾病,似乎也能够适应疾病,而不会出现临床上显著的心理问题。了解这些人能够适应并在许多情况下从他们的经历中找到积极意义的过程很重要。虽然已经提出了一些模型来解释适应慢性病的各个方面,但需要一种综合方法来描述适应过程是如何演变的。这样的理解将使临床医生能够改进促进适应并可能预防长期问题的干预措施。在提供最佳水平的医疗保健时,促进患者对疾病的适应必须是优先事项。