Safa Mitra, Boroujerdi Fatemeh Ghassem, Talischi Firouzeh, Masjedi Mohammad Reza
Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Tanaffos. 2014;13(3):23-30.
Treatment of patients with chronic conditions requiring hospitalization requires patient acceptance and cooperation and adoption of coping strategies. Inappropriate coping strategies such as substance abuse are concerning in the course of treatment. This study sought to explore the association of coping strategies with suicidal behavior in substance abusers and non substance abuser patients with chronic pulmonary diseases namely asthma and chronic obstructive pulmonary disease (COPD).
This comparative study was performed on 100 patients with asthma and COPD selected via convenience sampling. Subjects with and without substance abuse were separated into two groups of 50 patients each. Ways of Coping Questionnaire of Lazarus (WOCQ) and Suicide Behavior Questionnaire-Revised (SBQ-R) were completed by them. Five Persian speaking patients rated this questionnaire to be easily understandable in the pre-test stage. Cronbach's alpha was calculated to measure the internal consistency.
The mean (±standard deviation) age of participants was 40 (±14) years; 58% of individuals were men; 62% had chosen problem-focused coping. The most abused substances were cigarettes (78%) and opium (42%); 6% of substance abusers had thought about suicide five times or more in the past year; 5% of substance abusers had seriously attempted suicide. Tendency to commit suicide was greater in men, substance abusers and participants who had chosen emotion-focused coping strategies, based on a regression model. Average score of suicide tendency was significantly higher in substance abusers (B=2.196, P =0.007).
Chronic disease is a crisis and patients need to acquire appropriate coping strategies to deal with it, especially in substance abusers and suicidal patients. Precise recognition of coping strategies in chronic pulmonary patients with substance abuse is necessary via a team cooperation among psychiatrics, psychologists and an internal physician in hospitals because medical treatment alone is not sufficient in such cases.
对需要住院治疗的慢性病患者进行治疗需要患者的接受与配合，并采用应对策略。在治疗过程中，诸如药物滥用等不适当的应对策略令人担忧。本研究旨在探讨应对策略与药物滥用者及非药物滥用者（患有慢性肺部疾病，即哮喘和慢性阻塞性肺疾病（COPD））自杀行为之间的关联。
本比较研究对通过便利抽样选取的100例哮喘和COPD患者进行。有和没有药物滥用的受试者被分为两组，每组50例患者。他们完成了拉扎勒斯应对方式问卷（WOCQ）和自杀行为问卷修订版（SBQ-R）。在预测试阶段，5名说波斯语的患者认为该问卷易于理解。计算克朗巴哈系数以测量内部一致性。
参与者的平均（±标准差）年龄为40（±14）岁；58%为男性；62%选择了以问题为中心的应对方式。滥用最多的物质是香烟（78%）和鸦片（42%）；6%的药物滥用者在过去一年中曾5次或更多次想到自杀；5%的药物滥用者曾认真尝试自杀。根据回归模型，男性、药物滥用者和选择以情绪为中心应对策略的参与者自杀倾向更大。药物滥用者的自杀倾向平均得分显著更高（B=2.196，P =0.007）。
慢性病是一种危机，患者需要获得适当的应对策略来应对，尤其是药物滥用者和有自杀倾向的患者。医院的精神科医生、心理学家和内科医生需要团队合作，精确识别慢性肺部疾病合并药物滥用患者的应对策略，因为在此类情况下仅靠药物治疗是不够的。
