Wilson Debra Rose
Walden University, Minneapolis, MN, USA.
West J Nurs Res. 2010 Feb;32(1):103-27. doi: 10.1177/0193945909343703. Epub 2009 Dec 1.
Among the many sequelae of childhood sexual abuse is a maladaptive response to stress. Stress has been linked to a reduction in the immune system's ability to resist disease. The purpose of this exploratory mixed-method study is to examine the experience of stress management training for 35 adult survivors of childhood sexual abuse. Data gathered for analysis include pre- and postintervention saliva samples for sIgA, Ways of Coping Questionnaire, and a postintervention qualitative interview. Stress management strategies enhance immunity (increase in salivary immunoglobulin A, p < .05) and coping (less distancing, p < .001; less escape-avoidance, p < .001; more planful problem solving, p < .01; and more positive reappraisal, p < .001). Grounded theory analysis finds three themes emerging: hypervigilance , an outward-focused hyperawareness; somatic detachment, a lack of inward focus on self; and healing pathway, the process of healing from the abuse. Healing is possible.
童年期性虐待的众多后遗症之一是对应激的适应不良反应。应激与免疫系统抵抗疾病能力的降低有关。这项探索性混合方法研究的目的是考察35名童年期性虐待成年幸存者接受压力管理训练的经历。收集用于分析的数据包括干预前后的唾液样本以检测分泌型免疫球蛋白A、应对方式问卷,以及干预后的定性访谈。压力管理策略可增强免疫力(唾液免疫球蛋白A增加,p < 0.05)和应对能力(更少疏离,p < 0.001;更少逃避,p < 0.001;更多有计划地解决问题,p < 0.01;更多积极重新评价,p < 0.001)。扎根理论分析发现出现了三个主题:过度警觉,一种向外聚焦的过度意识;躯体超脱,缺乏对自我的内在关注;以及康复途径,从虐待中康复的过程。康复是有可能的。