Tielemans Nienke S, Schepers Vera P, Visser-Meily Johanna M, Post Marcel W, van Heugten Caroline M
Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands; Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
Arch Phys Med Rehabil. 2015 Aug;96(8):1484-91. doi: 10.1016/j.apmr.2015.04.009. Epub 2015 Apr 25.
To examine the associations of proactive coping and self-efficacy with psychosocial outcomes in individuals after stroke.
Cross-sectional study. Regression analyses were performed.
Outpatient settings of hospitals and rehabilitation centers.
Individuals after stroke (N=112; mean age ± SD, 57.1±8.9y; mean time ± SD since stroke, 18.9±28.5mo).
Not applicable.
Proactive coping was measured using the Utrecht Proactive Coping Competence scale (UPCC), and self-efficacy was measured using the General Self-Efficacy Scale (GSES). Psychosocial outcomes were measured as (1) participation with the use of the restriction and satisfaction subscales of the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation); (2) emotional problems with the use of the Hospital Anxiety and Depression Scale (HADS); (3) life satisfaction with the use of 2 questions (2LS); and (4) health-related quality of life (HRQOL) with the use of the Short Stroke-Specific Quality of Life scale (SS-QOL-12).
Higher UPCC scores were associated with lower HADS scores (β=-.55, P<.001) and with higher USER-Participation satisfaction (β=.31, P=.001), 2LS (β=.34, P<.001), and SS-QOL-12 scores (β=.44, P<.001). The influence of UPCC scores on HRQOL was indirect through self-efficacy. Higher GSES scores were associated with higher UPCC scores (β=.65, P<.001), which in turn were associated with lower HADS scores (β=-.51, P<.001). GSES scores were directly associated with higher SS-QOL-12 scores (β=.32, P=.002). GSES scores did not influence the association between UPCC scores and any of the psychosocial outcomes (all P>.0025).
Proactive coping and self-efficacy have different associations with each of the psychosocial outcomes. Therefore, outcome-specific models appear to be necessary to describe these associations.
探讨中风后个体积极应对和自我效能与心理社会结局之间的关联。
横断面研究。进行回归分析。
医院和康复中心的门诊环境。
中风后个体（N = 112；平均年龄±标准差，57.1±8.9岁；中风后平均时间±标准差，18.9±28.5个月）。
不适用。
使用乌得勒支积极应对能力量表（UPCC）测量积极应对，使用一般自我效能量表（GSES）测量自我效能。心理社会结局的测量指标为：（1）使用乌得勒支康复参与评估量表（USER - 参与）的限制和满意度子量表测量参与情况；（2）使用医院焦虑抑郁量表（HADS）测量情绪问题；（3）使用两个问题（2LS）测量生活满意度；（4）使用简短的特定中风生活质量量表（SS - QOL - 12）测量与健康相关的生活质量（HRQOL）。
较高的UPCC得分与较低的HADS得分相关（β = -0.55，P <.001），与较高的USER - 参与满意度（β = 0.31，P = 0.001）、2LS（β = 0.34，P <.001）和SS - QOL - 12得分（β = 0.44，P <.001）相关。UPCC得分对HRQOL的影响通过自我效能间接体现。较高的GSES得分与较高的UPCC得分相关（β = 0.65，P <.001），而UPCC得分又与较低的HADS得分相关（β = -0.51，P <.001）。GSES得分与较高的SS - QOL - 12得分直接相关（β = 0.32，P = 0.002）。GSES得分不影响UPCC得分与任何心理社会结局之间的关联（所有P >.0025）。
积极应对和自我效能与各心理社会结局之间存在不同的关联。因此，似乎需要针对特定结局的模型来描述这些关联。
