Department of Psychological Medicine, Institute of Psychiatry, King's College London, London, United Kingdom.
J Pain Symptom Manage. 2012 May;43(5):819-32. doi: 10.1016/j.jpainsymman.2011.05.013. Epub 2012 Jan 30.
Representations of illness have been studied in several populations, but research is limited in palliative care.
To describe illness representations in a population with advanced disease receiving palliative care and to examine the relationship between illness perceptions, adaptive coping, and depression.
A cross-sectional survey of 301 consecutive eligible patients recruited from a palliative care service in south London, U.K. Measures used included the Brief Illness Perception Questionnaire (Brief IPQ), the Mental Adjustment to Cancer (MAC) Scale, and the Primary Care Evaluation of Mental Disorders Patient Health Questionnaire-9.
Scores were not normally distributed for most questions on the Brief IPQ. The correlations found between items on the Brief IPQ were understandable in the context of advanced disease. MAC helplessness-hopelessness and fighting spirit were highly correlated with items on the Brief IPQ in opposite directions. The Brief IPQ domains of consequences, identity, concern, personal control, and emotion were associated with depression, a relationship that was not explained by adaptive coping. Seven causal attribution themes were identified: don't know, personal responsibility, exposure, pathological process, intrinsic personal factors, chance, fate or luck, and other. Both lung cancer diagnosis and gender were found to be independently associated with personal responsibility attribution. None of the attribution themes were associated with the presence of depression.
Assessment of illness perceptions in palliative care is likely to yield important information about risk of depression and will help clinicians to personalize management of advanced disease.
在多个群体中已经研究了疾病的表现形式，但在姑息治疗中，相关研究有限。
描述接受姑息治疗的晚期疾病患者的疾病表现，并探讨疾病认知、适应性应对和抑郁之间的关系。
对英国伦敦南部姑息治疗服务机构中连续招募的 301 名符合条件的患者进行横断面调查。使用的测量工具包括简要疾病认知问卷（Brief IPQ）、癌症心理调整量表（MAC）和初级保健评估心理健康问卷-9（Patient Health Questionnaire-9）。
大多数Brief IPQ 问题的得分没有正态分布。在晚期疾病的背景下，Brief IPQ 中各项目之间的相关性是可以理解的。MAC 的无助无望和斗志与Brief IPQ 的项目呈相反方向的高度相关。Brief IPQ 的后果、身份、关注、个人控制和情绪等领域与抑郁相关，而适应性应对并不能解释这种关系。确定了 7 个因果归因主题：不知道、个人责任、暴露、病理过程、内在个人因素、机会、命运或运气和其他。肺癌诊断和性别均被发现与个人责任归因独立相关。没有任何归因主题与抑郁的存在相关。
姑息治疗中对疾病认知的评估可能会提供有关抑郁风险的重要信息，并有助于临床医生个性化管理晚期疾病。
