de Souza-Talarico Juliana Nery, Chaves Eliane Corrêa, Nitrini Ricardo, Caramelli Paulo
Department of Medical-Surgical Nursing, School of Nursing, University of São Paulo, São Paulo, Brazil.
J Clin Nurs. 2009 Feb;18(3):457-65. doi: 10.1111/j.1365-2702.2008.02508.x. Epub 2008 Nov 29.
To investigate stress intensity and coping style in older people with mild Alzheimer's disease.
The potential risk assessment of a stress event and the devising of coping strategies are dependent on cognitive function. Although older individuals with Alzheimer's disease present significant cognitive impairment, little is known about how these individuals experience stress events and select coping strategies in stress situations.
Survey.
A convenient sample of 30 cognitively healthy older people and 30 individuals with mild Alzheimer's disease were given an assessment battery of stress indicators (Symptom Stress List, Cornell Scale for Depression in Dementia, State-Trait Anxiety Inventory), coping style (Jalowiec Coping Scale) and cognitive performance (mini-mental state exam) were applied in both groups. Statistical analysis of the data employed the Mann-Whitney test to compare medians of stress indicators and coping style, Fischer's exact test to compare proportions when expected frequencies were lower than five, and Spearman's correlation coefficient to verify correlation between coping style and cognitive performance.
Both groups suffered from the same stress intensity (p = 0.254). Regarding coping styles, although differences were not statistically significant (p = 0.124), emotion-oriented coping was predominant in the patients with Alzheimer's disease. However, those individuals displaying better cognitive performance in the Alzheimer's disease group had selected coping strategies focused on problem solving (p = 0.0074).
Despite a tendency for older people with Alzheimer's disease to select escape strategies and emotional control, rather than attempting to resolve or lesser the consequences arising from a problem, coping ultimately depends on cognitive performance of the individual.
The findings of this study provide information and data to assist planning of appropriate support care for individuals with Alzheimer's disease who experience stress situations, based on their cognitive performance.
调查轻度阿尔茨海默病老年人的应激强度及应对方式。
应激事件的潜在风险评估及应对策略的制定依赖于认知功能。尽管患有阿尔茨海默病的老年人存在显著的认知障碍，但对于这些个体如何经历应激事件以及在应激情况下选择应对策略却知之甚少。
调查。
选取30名认知健康的老年人和30名轻度阿尔茨海默病患者作为便利样本，对两组均进行应激指标评估量表（症状应激清单、痴呆抑郁康奈尔量表、状态-特质焦虑量表）、应对方式（贾洛维茨应对量表）及认知表现（简易精神状态检查）的测评。数据的统计分析采用曼-惠特尼检验比较应激指标和应对方式的中位数，采用费舍尔精确检验比较预期频数低于5时的比例，采用斯皮尔曼相关系数验证应对方式与认知表现之间的相关性。
两组的应激强度相同（p = 0.254）。关于应对方式，尽管差异无统计学意义（p = 0.124），但阿尔茨海默病患者中以情绪为导向的应对方式占主导。然而，在阿尔茨海默病组中认知表现较好的个体选择了侧重于解决问题的应对策略（p = 0.0074）。
尽管患有阿尔茨海默病的老年人倾向于选择逃避策略和情绪控制，而不是试图解决问题或减轻问题产生的后果，但应对方式最终取决于个体的认知表现。
本研究结果提供了信息和数据，以帮助根据阿尔茨海默病患者的认知表现，为经历应激情况的患者规划适当的支持性护理。
