Curtis Ruth, Groarke Annmarie, Coughlan Robert, Gsel Amina
Department of Psychology, National University of Ireland, Galway University Rd., Galway, Ireland.
Patient Educ Couns. 2005 Nov;59(2):192-8. doi: 10.1016/j.pec.2004.10.015. Epub 2004 Dec 22.
This study examined the extent to which perceived stress, social support, coping and clinical disease indicators predict physical, psychological and social adjustment in patients with rheumatoid arthritis (RA). Participants were 59 women recruited at an outpatient clinic at University College Hospital, Galway. A range of psychological measures was administered and disease status was assessed by physician ratings of joint involvement and blood assays of inflammatory indices. Findings from correlational and hierarchical regression analyses revealed a number of statistically significant relationships (p<.01). Perceived stress was a better predictor than disease severity of positive and negative emotionality. Coping explained variability on positive and negative affect. Social support was linked to level of social activity. Results demonstrated that disease status predicted illness related functioning but did not predict emotional or social adjustment. Results suggest that a cognitive behavioural intervention to facilitate patient adjustment could usefully include management of stress and its appraisal, the fostering of adaptive coping strategies and utilization of social support resources. It is concluded that improving patient adjustment to rheumatoid arthritis has implications for medical care seeking.
本研究考察了感知压力、社会支持、应对方式和临床疾病指标在多大程度上能够预测类风湿性关节炎(RA)患者的身体、心理和社会适应情况。研究参与者为59名在戈尔韦大学学院医院门诊招募的女性。研究采用了一系列心理测量方法,并通过医生对关节受累情况的评级以及炎症指标的血液检测来评估疾病状态。相关分析和分层回归分析的结果显示了一些具有统计学意义的关系(p<.01)。与疾病严重程度相比,感知压力是正负情绪的更好预测指标。应对方式解释了正负情绪的变化情况。社会支持与社交活动水平相关。结果表明,疾病状态能够预测与疾病相关的功能,但不能预测情绪或社会适应情况。结果提示,促进患者适应的认知行为干预可以有效地包括压力管理及其评估、培养适应性应对策略以及利用社会支持资源。研究得出结论,改善患者对类风湿性关节炎的适应情况对寻求医疗护理具有重要意义。