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简易应对方式问卷(Brief COPE)在痴呆症患者照料者中的效度和信度:LASER-AD研究

Validity and reliability of the brief COPE in carers of people with dementia: the LASER-AD Study.

作者信息

Cooper Claudia, Katona Cornelius, Livingston Gill

机构信息

Department of Mental Health Sciences (Archway Campus), UCL, London, United Kingdom.

出版信息

J Nerv Ment Dis. 2008 Nov;196(11):838-43. doi: 10.1097/NMD.0b013e31818b504c.

Abstract

The Brief COPE is a self-completed questionnaire measuring coping strategies. It comprises 14 subscales for which psychometric properties are described. Three composite subscales measuring emotion-focused, problem-focused, and dysfunctional coping have proved useful in clinical research and have content validity. We report psychometric properties of these subscales for the first time. One hundred twenty-five family carers of people with Alzheimer's disease completed the Brief COPE at time 1, 92 (82.9% of eligible carers) a year later, and 74 (77.1%) 2 years later. Internal consistencies were good for emotion-focused, problem-focused, and dysfunctional subscales (alpha = 0.72, 0.84, 0.75). Test-retest reliability over a year was demonstrated for emotion-focused, problem-focused, and dysfunctional subscales among carers in whom burden scores did not change significantly (r = 0.58, r = 0.72, r = 0.68; p < 0.001). Change in burden score over 2 years correlated with change in problem-focused and dysfunctional (r = 0.33, r = 0.32; p < 0.01) subscales, indicating sensitivity to change, but not with change on the emotion-focused scale. Change in emotion-focused coping correlated with change in problem-focused and dysfunctional coping (r = 0.40, r = 0.26; p < 0.05). Regression analyses indicated convergent and concurrent validity: emotion-focused coping was predicted by secure attachment (beta = 0.23) and by problem-focused coping (beta = 0.68); dysfunctional coping by burden (beta = 0.36) and less secure attachment (beta = -0.25) and problem-focused coping (beta = 0.31;all p < 0.05). The model predicting problem-focused coping included avoidant attachment (beta = 0.22; p = 0.014), social support (beta = 0.10; p = 0.25), care recipient activities of daily living impairment (beta = 0.12; p = 0.14) and less secure attachment (beta = -0.25; p = 0.011) and emotion-focused (beta = 0.53; p < 0.001) and dysfunctional coping (beta = 0.25, p = 0.006). These subscales are potentially useful in clinical research as they reflect possible components of interventions to change coping, although more information about sensitivity to change of the emotion-focused subscale is needed.

摘要

简易应对方式问卷(The Brief COPE)是一份用于测量应对策略的自填式问卷。它由14个分量表组成,其心理测量学特性已被描述。三个综合分量表分别测量以情绪为中心、以问题为中心和功能失调的应对方式,已证明在临床研究中很有用且具有内容效度。我们首次报告这些分量表的心理测量学特性。125名阿尔茨海默病患者的家庭照顾者在第1次时完成了简易应对方式问卷,一年后有92名(占符合条件照顾者的82.9%)完成,两年后有74名(占77.1%)完成。以情绪为中心、以问题为中心和功能失调的分量表的内部一致性良好(α系数分别为0.72、0.84、0.75)。在负担得分没有显著变化的照顾者中,以情绪为中心、以问题为中心和功能失调的分量表在一年中的重测信度得到了验证(r = 0.58,r = 0.72,r = 0.68;p < 0.001)。两年内负担得分的变化与以问题为中心和功能失调的分量表的变化相关(r = 0.33,r = 0.32;p < 0.01),表明对变化敏感,但与以情绪为中心的分量表的变化无关。以情绪为中心的应对方式的变化与以问题为中心和功能失调的应对方式的变化相关(r = 0.40,r = 0.26;p < 0.05)。回归分析表明具有收敛效度和同时效度:安全依恋(β = 0.23)以及以问题为中心的应对方式(β = 0.68)可预测以情绪为中心的应对方式;负担(β = 0.36)、较不安全的依恋(β = -0.25)以及以问题为中心的应对方式(β = 0.31;所有p < 0.05)可预测功能失调的应对方式。预测以问题为中心的应对方式的模型包括回避型依恋(β = 0.22;p = 0.014)、社会支持(β = 0.10;p = 0.25)、受照顾者日常生活活动能力受损(β = 0.12;p = 0.14)、较不安全的依恋(β = -0.25;p = 0.011)、以情绪为中心的应对方式(β = 0.53;p < 0.001)以及功能失调的应对方式(β = 0.25,p = 0.006)。这些分量表在临床研究中可能有用,因为它们反映了改变应对方式的干预措施的可能组成部分,尽管需要更多关于以情绪为中心的分量表对变化的敏感性的信息。

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