Department of Cardiothoracic Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA.
Am J Public Health. 2013 May;103(5):931-7. doi: 10.2105/AJPH.2012.300748. Epub 2012 Sep 20.
We examined early maladaptive personal attributes (e.g., depression), later lung disease, and later maladaptive personal attributes over a significant part of a woman's life.
We gathered longitudinal data on a prospective cohort of community-dwelling women (n = 498) followed from young adulthood to late midlife. Results. We used structural equation modeling to assess the interrelations of maladaptive personal attributes, cigarette smoking, lung disease, and financial strain. The results supported a mediational model through which early maladaptive personal attributes were associated with smoking (b = 0.17, P < .001), which in turn predicted later lung disease (b = 0.33, P < .001), and lung disease was related to later family financial difficulties (b = 0.09, P < .05), which in turn were associated with later maladaptive personal attributes (b = 0.35, P < .001).
Our results address a number of important public health and clinical issues. An understanding of the interrelations of smoking, underlying mental health conditions, financial stress, and later mental health conditions on the part of physicians and other health care providers can be critical in managing patients with lung disease.
我们考察了女性生命中相当长一段时间内的早期适应不良的个人特征（例如抑郁）、晚期肺部疾病和晚期适应不良的个人特征。
我们收集了一个社区居住的女性前瞻性队列的纵向数据（n=498），随访至中年后期。结果。我们使用结构方程模型评估了适应不良的个人特征、吸烟、肺部疾病和经济压力之间的相互关系。结果支持了一个中介模型，其中早期适应不良的个人特征与吸烟有关（b=0.17，P<.001），吸烟反过来又预测了晚期肺部疾病（b=0.33，P<.001），肺部疾病与晚期家庭经济困难有关（b=0.09，P<.05），而晚期家庭经济困难又与晚期适应不良的个人特征有关（b=0.35，P<.001）。
我们的结果解决了一些重要的公共卫生和临床问题。了解医生和其他医疗保健提供者在吸烟、潜在心理健康状况、经济压力和晚期心理健康状况之间的相互关系，对于管理肺部疾病患者至关重要。
