Schröder Carin, Johnston Marie, Teunissen Laurien, Notermans Nicolette, Helders Paul, van Meeteren Nico
Department of Neurology and Neurosurgery, Rudolf Magnus Institute of Neuroscience, Sections of Rehabilitation Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands.
Arch Phys Med Rehabil. 2007 Jan;88(1):63-9. doi: 10.1016/j.apmr.2006.10.024.
To investigate (1) whether control perceptions (person's perception of ease or difficulty of performing behavior) and emotions contribute to activity limitations and if so (2) whether these variables mediate the relation between impairment and activity limitations in patients with chronic idiopathic axonal polyneuropathy (CIAP).
Cross-sectional study.
Outpatient clinics of a university medical center.
Fifty-six patients diagnosed with CIAP.
Not applicable.
Control perceptions about performing activities (questionnaire based on the theory of planned behavior), emotions (Hospital Anxiety and Depression Scale), activity limitations (performance: Shuttle Walk Test [SWT]; self-report: Medical Outcomes Study 36-Item Short-Form Health Survey [SF-36] physical functioning subscale, self-reported ability to walk), and physical impairments (muscle strength, sensory function).
Control perceptions significantly (P<.01) correlated with all measures of activity limitations (r range, .58-.69). Hierarchical multiple regression analyses showed that perceived control explained 9% of the variance in the SWT (beta=.34, P<.01), 12% in the SF-36 (beta=.40, P<.01), and 24% in ability to walk (beta=.54, P<.01). In all measures of activity limitations, perceived control significantly mediated the effect of impairment.
Perceived control explained and mediated variance in activity limitations, whereas emotions did not. This suggests that increasing patients' perceptions of control might enhance performance of activities, even without changes in impairment.
研究(1)控制认知(个体对执行行为的难易程度的认知)和情绪是否导致活动受限,如果是,(2)这些变量是否介导慢性特发性轴索性多神经病(CIAP)患者损伤与活动受限之间的关系。
横断面研究。
大学医学中心门诊。
56例被诊断为CIAP的患者。
不适用。
关于执行活动的控制认知(基于计划行为理论的问卷)、情绪(医院焦虑抑郁量表)、活动受限(表现:往返步行试验[SWT];自我报告:医学结局研究36项简短健康调查[SF-36]身体功能分量表、自我报告的行走能力)和身体损伤(肌肉力量、感觉功能)。
控制认知与所有活动受限指标显著相关(P<0.01,r范围为0.58 - 0.69)。分层多元回归分析显示,感知控制解释了SWT中9%的变异(β = 0.34,P<0.01),SF-36中12%的变异(β = 0.40,P<0.01),以及行走能力中24%的变异(β = 0.54,P<0.01)。在所有活动受限指标中,感知控制显著介导了损伤的影响。
感知控制解释并介导了活动受限中的变异,而情绪则没有。这表明,即使损伤没有改变,提高患者的控制认知可能会增强活动表现。