Brands Ingrid, Köhler Sebastian, Stapert Sven, Wade Derick, van Heugten Caroline
Department of Neurorehabilitation, Libra Rehabilitation Medicine & Audiology, Eindhoven, The Netherlands.
Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands.
Arch Phys Med Rehabil. 2014 Dec;95(12):2327-34. doi: 10.1016/j.apmr.2014.06.006. Epub 2014 Jun 25.
To investigate the relations linking self-efficacy and coping to quality of life (QOL) and social participation and what effect self-efficacy, changes in self-efficacy, and coping style have on long-term QOL and social participation.
Prospective clinical cohort study.
General hospitals, rehabilitation centers.
Patients with newly acquired brain injury (ABI) (N=148) were assessed at baseline (start outpatient rehabilitation or discharge hospital/inpatient rehabilitation; mean time since injury, 15wk) and 1 year later (mean time since injury, 67wk).
Not applicable.
QOL was measured with the EuroQuol 5D (the EQ-5D index and the EQ-5D visual analog scale [EQ VAS]) and the 9-item Life Satisfaction Questionnaire (LiSat-9), social participation with the modified Frenchay Activities Index, coping with the Coping Inventory for Stressful Situations, and self-efficacy with the Traumatic Brain Injury Self-efficacy Questionnaire.
At baseline, self-efficacy moderated the effect of emotion-oriented coping on the EQ-5D index and of avoidance coping on the EQ VAS. Self-efficacy mediated the relation between emotion-oriented coping and LiSat-9. An increase in self-efficacy over time predicted better scores on the EQ-5D index (β=.30), the EQ VAS (β=.49), and LiSat-9 (β=.44) at follow-up. In addition, higher initial self-efficacy (β=.40) predicted higher LiSat-9 scores at follow-up; higher initial emotion-oriented coping (β=-.23) predicted lower EQ VAS scores at follow-up. Higher modified Frenchay Activities Index scores at follow-up were predicted by higher self-efficacy (β=.19) and higher task-oriented coping (β=.14) at baseline (combined R(2)=5.1%).
Self-efficacy and coping predict long-term QOL but seem less important in long-term social participation. High self-efficacy protects against the negative effect of emotion-oriented coping. Enhancing self-efficacy in the early stage after ABI may have beneficial long-term effects.
探讨自我效能感和应对方式与生活质量（QOL）及社会参与之间的关系，以及自我效能感、自我效能感的变化和应对方式对长期生活质量和社会参与有何影响。
前瞻性临床队列研究。
综合医院、康复中心。
新发生脑损伤（ABI）患者（N = 148）在基线时（开始门诊康复或出院/住院康复；受伤后的平均时间为15周）和1年后（受伤后的平均时间为67周）接受评估。
不适用。
使用欧洲五维度健康量表（EQ - 5D指数和EQ - 5D视觉模拟量表[EQ VAS]）以及9项生活满意度问卷（LiSat - 9）测量生活质量，使用改良的Frenchay活动指数测量社会参与，使用应激情境应对量表测量应对方式，使用创伤性脑损伤自我效能量表测量自我效能感。
在基线时，自我效能感调节了以情绪为导向的应对方式对EQ - 5D指数的影响以及回避应对方式对EQ VAS的影响。自我效能感介导了以情绪为导向的应对方式与LiSat - 9之间的关系。随着时间推移自我效能感的提高预测了随访时EQ - 5D指数（β = 0.30）、EQ VAS（β = 0.49）和LiSat - 9（β = 0.44）得分更高。此外，较高的初始自我效能感（β = 0.40）预测了随访时较高的LiSat - 9得分；较高的初始以情绪为导向的应对方式（β = - 0.23）预测了随访时较低的EQ VAS得分。随访时较高的改良Frenchay活动指数得分由基线时较高的自我效能感（β = 0.19）和较高的以任务为导向的应对方式（β = 0.14）预测（综合R² = 5.1%）。
自我效能感和应对方式可预测长期生活质量，但在长期社会参与中似乎不太重要。高自我效能感可抵御以情绪为导向的应对方式的负面影响。在ABI后的早期提高自我效能感可能具有有益的长期效果。
