Braden C J
College of Nursing, University of Arizona, Tucson.
Nurs Res. 1990 Jan-Feb;39(1):42-7.
The purpose of this study was to increase understanding of the essential dynamics of learned response to chronic illness experience. A Self-Help Model was tested with 396 subjects with diagnoses of rheumatoid arthritis or arthritis-related conditions. Self-Help Model variables include disease characteristics, background inputs, monitoring, severity of illness, dependency, uncertainty, enabling skill, self-help, and life quality. Severity of illness, disease characteristics, background inputs, and monitoring explained 24% of the variance in dependency and 40% of the variance in uncertainty. Monitoring was the strongest contributor to explanation of enabling skill; however, only a small amount of the variance in enabling skill was explained, adjusted R2 = .15. Enabling skill was the strongest predictor of self-help, beta = .42, minimizing the influence of uncertainty, beta = -.23 and dependency, beta = -.10, on self-help, R2 = .55. Self-help was strongly related to life quality, beta = .62. Self-help and uncertainty explained 49% of the variance in life quality. Results suggest a basis for interventions that reduce dependency and uncertainty and enhance enabling skill.
本研究的目的是增进对慢性病经历习得性反应基本动态的理解。对396名被诊断患有类风湿性关节炎或关节炎相关病症的受试者进行了自助模型测试。自助模型变量包括疾病特征、背景输入、监测、疾病严重程度、依赖程度、不确定性、赋能技能、自助和生活质量。疾病严重程度、疾病特征、背景输入和监测解释了依赖程度方差的24%以及不确定性方差的40%。监测是解释赋能技能的最强因素；然而，仅解释了赋能技能方差的一小部分，调整后的R2 = 0.15。赋能技能是自助的最强预测因素，β = 0.42，将不确定性（β = -0.23）和依赖程度（β = -0.10）对自助的影响降至最低，R2 = 0.55。自助与生活质量密切相关，β = 0.62。自助和不确定性解释了生活质量方差的49%。结果为减少依赖程度和不确定性以及增强赋能技能的干预措施提供了依据。
