Blake R L
Department of Family & Community Medicine, University of Missouri-Columbia 65212.
Fam Pract Res J. 1991 Mar;11(1):65-74.
Psychosocial correlates of morbidity and functional status were examined in 44 white adults with chronic lung disease. Demographic characteristics, functional status, stressful life changes, social supports, and self-esteem were assessed at baseline by a self-administered questionnaire. Hospital days, bed-disability days, restricted-activity days, and physician visits were then measured prospectively by mailed questionnaire over the next 6 months. There were no cross-sectional associations of psychosocial variables with demographic characteristics. Better functional status (measured by the Sickness Impact Profile) was associated with a lower 12-month life-change score (measured by the Social Readjustment Rating Scale), with stronger social supports (measured by a 13-item index), and with higher self-esteem (measured by the Rosenberg Scale). On bivariate analysis, higher life-change score predicted higher levels of all four morbidity variables; low social supports predicted increased bed days, restricted-activity days, and physician visits; and low self-esteem predicted high restricted-activity. After controlling for demographic characteristics and baseline function by multivariate analysis, low social supports continued to predict higher rates of physician visits, but the other associations of psychosocial variables with morbidity were no longer statistically significant. The results suggest that patients with weak social supports have increased use of physician services.
对44名患有慢性肺病的白人成年人的发病情况和功能状态的心理社会相关因素进行了研究。在基线时通过自我管理问卷评估人口统计学特征、功能状态、应激性生活变化、社会支持和自尊。然后在接下来的6个月中通过邮寄问卷对住院天数、卧床残疾天数、活动受限天数和看医生次数进行前瞻性测量。心理社会变量与人口统计学特征之间没有横断面关联。更好的功能状态（通过疾病影响量表测量）与较低的12个月生活变化得分（通过社会再适应评定量表测量）、更强的社会支持（通过一个13项指标测量）和更高的自尊（通过罗森伯格量表测量）相关。在双变量分析中，较高的生活变化得分预测了所有四个发病变量的较高水平；低社会支持预测卧床天数、活动受限天数和看医生次数增加；低自尊预测高活动受限。在通过多变量分析控制了人口统计学特征和基线功能后，低社会支持继续预测更高的看医生率，但心理社会变量与发病之间的其他关联不再具有统计学意义。结果表明，社会支持薄弱的患者对医生服务的使用增加。
