儿童期起患慢性病的青年成年人的心理社会健康：疾病认知的作用。
Psychosocial well-being in young adults with chronic illness since childhood: the role of illness cognitions.
机构信息
Psychosocial Department, Emma Children's Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Psychosocial Department, Emma Children's Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands ; Psychosocial Department, Room A3-241, Emma Children's Hospital, Academic Medical Center, PO Box 22660, 1100 DD Amsterdam, The Netherlands.
出版信息
Child Adolesc Psychiatry Ment Health. 2014 Apr 15;8:12. doi: 10.1186/1753-2000-8-12. eCollection 2014.
BACKGROUND
More and more pediatric patients reach adulthood. Some of them are successfully integrating in adult life, but many others are not. Possibly Illness cognitions (IC) - the way people give meaning to their illness/disability - may play a role in individual differences on long-term adjustment. This study explored the association of IC with disease-characteristics and Health Related Quality of Life (HRQoL), anxiety and depression in young adults with a disability benefit due to childhood-onset chronic condition.
METHODS
In a cross-sectional study, young adults (22-31 years, N = 377) who claimed a disability benefit because of a somatic condition since childhood, completed the Illness Cognition Questionnaire (acceptance-helplessness-benefits), RAND-36 (HRQoL) and HADS (anxiety and depression) online. Besides descriptive statistics, linear regression analyses were conducted to predict (1) illness cognitions by age, gender and disease-characteristics, and (2) HRQoL (Mental and Physical Component Scale), Anxiety and Depression by illness cognitions, controlling for disease-characteristics, age and gender.
RESULTS
Respectively 90.2%, 83.8% and 53.3% of the young adults with a disability benefit experienced feelings of acceptance, benefits and helplessness. Several disease-characteristics were associated with IC. More acceptance and less helplessness were associated with better mental (β = 0.31; β = -0.32) and physical (β = 0.16; β = -0.15) HRQoL and with less anxiety (β = -0.27; β = 0.28) and depression (β = -0.29; β = 0.31).
CONCLUSIONS
IC of young adult beneficiaries were associated with their HRQoL and feelings of anxiety and depression. Early recognition of psychological distress and negative IC might be a key to the identification of pediatric patients at risk for long-term dysfunction. Identification of maladaptive illness cognitions enables the development of psychosocial interventions to optimise their well-being and adaptation to society.
背景
越来越多的儿科患者进入成年期。其中一些人成功地融入了成年生活，但也有很多人没有。可能疾病认知（IC）——人们赋予自己疾病/残疾意义的方式——在个体对长期适应的差异中发挥作用。本研究探讨了 IC 与疾病特征以及健康相关生活质量（HRQoL）、焦虑和抑郁在因儿童期起病的慢性疾病而获得残疾福利的年轻成年人中的相关性。
方法
在一项横断面研究中，377 名因儿童期起病的躯体疾病而获得残疾福利的年轻成年人（22-31 岁）在线完成了疾病认知问卷（接受-无助-获益）、RAND-36（HRQoL）和 HADS（焦虑和抑郁）。除了描述性统计外，还进行了线性回归分析，以预测（1）年龄、性别和疾病特征对疾病认知的影响，以及（2）疾病认知对 HRQoL（心理和生理成分量表）、焦虑和抑郁的影响，同时控制疾病特征、年龄和性别。
结果
分别有 90.2%、83.8%和 53.3%的残疾福利年轻成年人经历了接受感、获益感和无助感。几种疾病特征与 IC 有关。更多的接受感和更少的无助感与更好的心理（β=0.31；β=-0.32）和生理（β=0.16；β=-0.15）HRQoL 以及更少的焦虑（β=-0.27；β=0.28）和抑郁（β=-0.29；β=0.31）有关。
结论
年轻成年福利受益者的 IC 与其 HRQoL 以及焦虑和抑郁感有关。早期识别心理困扰和负面 IC 可能是识别长期功能障碍风险的儿科患者的关键。识别适应不良的疾病认知可以为制定社会心理干预措施提供依据，以优化他们的幸福感和适应社会的能力。
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