Department of Psychology, University of North Dakota, 319 Harvard Street, Stop 8380, Grand Forks, ND 58202, USA.
Psychol Health. 2011 Jul;26(7):835-53. doi: 10.1080/08870446.2010.506574. Epub 2011 May 24.
Prior research has established positive outcomes of health optimism (appraising one's health as good despite poor objective health (OH)) and negative outcomes of health pessimism (appraising health as poor despite good OH), yet little is known about their contributors. We examined the role of psychosocial factors (life event stress, depression, dispositional optimism, perceived social support) in health realism (appraising health in accordance with OH), optimism and pessimism among 489 older men and women. We then accounted for the psychosocial factors when examining multiple health correlates of health realism, optimism and pessimism. Controlling for age, gender and income, regression results indicate that depression and social support were associated with less health optimism, while dispositional optimism was associated with greater health optimism among those in poor OH. Dispositional optimism was associated with less health pessimism and life event stress was associated with greater pessimism among those in good OH. Beyond the effects of the psychosocial factors, structural equation model results indicate that health optimism was positively associated with healthy behaviours and perceived control over one's health; health pessimism was associated with poorer perceived health care management. Health optimism and pessimism have different psychosocial contributors and health correlates, validating the health congruence approach to later life well-being, health and survival.
先前的研究已经证实了健康乐观主义（尽管客观健康状况不佳，但仍对自己的健康状况进行积极评价）的积极结果和健康悲观主义（尽管客观健康状况良好，但仍对自己的健康状况进行消极评价）的消极结果，但对于其促成因素知之甚少。我们研究了心理社会因素（生活事件压力、抑郁、倾向性乐观、感知社会支持）在健康现实主义（根据客观健康状况评估健康）、乐观主义和悲观主义中的作用，该研究共纳入了 489 名老年男女。然后，我们在考察健康现实主义、乐观主义和悲观主义与多种健康相关因素的关系时，考虑了这些心理社会因素。在控制年龄、性别和收入的情况下，回归结果表明，抑郁和社会支持与较低的健康乐观主义相关，而倾向性乐观与客观健康状况较差者的健康乐观主义相关。在客观健康状况良好者中，倾向性乐观与较低的健康悲观主义相关，生活事件压力与较高的悲观主义相关。除了心理社会因素的影响外，结构方程模型的结果表明，健康乐观主义与健康行为和对自身健康的控制感呈正相关；健康悲观主义与较差的医疗保健管理感知相关。健康乐观主义和悲观主义有不同的心理社会促成因素和健康相关因素，这验证了健康一致性方法对晚年幸福感、健康和生存的有效性。
