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掌握和应对能力可以减轻 HIV 感染者急性和慢性应激源对心理健康相关生活质量的负面影响。

Mastery and coping moderate the negative effect of acute and chronic stressors on mental health-related quality of life in HIV.

机构信息

The Ontario HIV Treatment Network, Toronto, Canada.

出版信息

AIDS Patient Care STDS. 2011 Jun;25(6):371-81. doi: 10.1089/apc.2010.0165. Epub 2011 Apr 14.

DOI:10.1089/apc.2010.0165
PMID:21492004
Abstract

Acute and chronic life stressors have a detrimental effect on the health of people living with HIV. Psychosocial resources such as mastery, coping, and social support may play a critical role in moderating the negative effects of stressors on health-related quality of life. A total of 758 participants provided baseline enrolment data on demographics (age, gender, ethnicity, sexual orientation, education, employment, income), clinical variables (CD4 counts, viral load, AIDS-defining condition, time since HIV diagnosis), psychosocial resources (mastery, coping, social support), life stressors (National Population Health Survey [NPHS] Stress Questionnaire), and health-related quality of life (SF-36). We performed hierarchical multivariate regression analyses to evaluate the potential moderating effects of psychosocial resources on the relationship between stressors and health-related quality of life. The top three stressors reported by participants were trying to take on too many things at once (51%), not having enough money to buy the things they needed (51%), and having something happen during childhood that scared them so much that they thought about it years later (42%). Life stressors were significantly and inversely associated with both physical and mental health-related quality of life. Mastery and maladaptive coping had significant moderating effects on mental health but not on physical health. These results suggest that developing interventions that improve mastery and reduce maladaptive coping may minimize the negative impact of life stressors on the mental health of people with HIV. They also highlight that it is important for clinicians to be mindful of the impact of life stressors on the health of patients living with HIV.

摘要

急性和慢性生活应激源对 HIV 感染者的健康有不利影响。心理社会资源,如掌握、应对和社会支持,可能在调节应激源对健康相关生活质量的负面影响方面发挥关键作用。共有 758 名参与者提供了人口统计学数据(年龄、性别、种族、性取向、教育、就业、收入)、临床变量(CD4 计数、病毒载量、艾滋病定义疾病、HIV 诊断后时间)、心理社会资源(掌握、应对、社会支持)、生活应激源(国家人口健康调查[NPHS]应激问卷)和健康相关生活质量(SF-36)的基线登记数据。我们进行了分层多元回归分析,以评估心理社会资源对应激源与健康相关生活质量之间关系的潜在调节作用。参与者报告的前三大压力源是同时承担太多事情(51%)、没有足够的钱购买所需的东西(51%)和童年时期发生的事情让他们非常害怕,以至于多年后还在想(42%)。生活应激源与身心健康相关生活质量呈显著负相关。掌握和适应不良的应对方式对心理健康有显著的调节作用,但对身体健康没有影响。这些结果表明,开发旨在提高掌握能力和减少适应不良应对方式的干预措施可能会最小化生活应激源对 HIV 感染者心理健康的负面影响。它们还强调,临床医生注意生活应激源对 HIV 感染者健康的影响非常重要。

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