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应对策略对类风湿关节炎患者身心福祉的影响。

The impact of coping strategies on mental and physical well-being in patients with rheumatoid arthritis.

机构信息

Department of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany.

出版信息

Semin Arthritis Rheum. 2012 Feb;41(4):545-55. doi: 10.1016/j.semarthrit.2011.07.009.

Abstract

OBJECTIVE

To investigate the relation of coping strategies to coping effectiveness, helplessness, and mental as well as physical well-being as indicators of quality of life.

METHODS

Cross-sectional international study. Coping strategies were assessed by a validated 18-item questionnaire, while coping effectiveness and helplessness were measured by numerical rating scales. The predictability of both and quality of life (SF-36) was evaluated by multiple linear regression including demographic and disease-related factors.

RESULTS

Four hundred thirty-four rheumatoid arthritis (RA) patients (77% female; mean age 55.96 ± 13.34 years) were included. Distancing was the coping strategy used most frequently in RA patients (mean ± SD 1.89 ± 0.78 on a scale ranging from 0 to 3). Female RA patients used coping strategies significantly more often than males, whereas age and duration of disease did not seem to influence the use of coping strategies. Cognitive reframing and active problem-solving contributed to coping effectiveness while emotional expression was related to helplessness. Coping effectiveness was positively related to general health perception, suggesting certain coping strategies to be effective in influencing the quality of life of RA patients.

CONCLUSIONS

Coping strategies used in RA are dependent on gender, but not on age. The use of problem-focused coping strategies may allow for an improved coping effectiveness in patients with RA, while also influencing mental and physical well-being as indicators of quality of life. Coping should therefore be considered as an important factor in determining the overall health state of patients with RA.

摘要

目的

探讨应对策略与应对效能、无助感以及心理和生理健康作为生活质量指标的关系。

方法

这是一项跨国际的横断面研究。通过一个经过验证的 18 项问卷来评估应对策略,而应对效能和无助感则通过数字评分量表进行衡量。通过多元线性回归评估两者的可预测性以及生活质量(SF-36),包括人口统计学和疾病相关因素。

结果

共纳入 434 名类风湿关节炎(RA)患者(77%为女性;平均年龄 55.96 ± 13.34 岁)。在 RA 患者中,回避是最常使用的应对策略(范围为 0 到 3,平均值 ± 标准差为 1.89 ± 0.78)。女性 RA 患者比男性更频繁地使用应对策略,而年龄和疾病持续时间似乎并不影响应对策略的使用。认知重构和积极解决问题有助于应对效能,而情绪表达则与无助感有关。应对效能与一般健康感知呈正相关,表明某些应对策略可有效影响 RA 患者的生活质量。

结论

RA 患者使用的应对策略取决于性别,而与年龄无关。使用问题聚焦型应对策略可能会提高 RA 患者的应对效能,同时也会影响心理和生理健康作为生活质量的指标。因此,应对策略应被视为确定 RA 患者整体健康状况的重要因素。

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