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宗教应对及其对炎症性肠病患者心理困扰、药物依从性和生活质量的影响。

Religious coping and its influence on psychological distress, medication adherence, and quality of life in inflammatory bowel disease.

作者信息

Freitas Thiago H, Hyphantis Thomas N, Andreoulakis Elias, Quevedo João, Miranda Hesley L, Alves Gilberto S, Souza Marcellus H, Braga Lúcia L, Pargament Kenneth I, Soczynska Joanna K, McIntyre Roger S, Carvalho André F

机构信息

Department of Clinical Medicine, Universidade Federal do Ceará, Fortaleza, CE, BR.

Department of Psychiatry, University of Ioannina, Ioannina, GR.

出版信息

Braz J Psychiatry. 2015 Jul-Sep;37(3):219-27. doi: 10.1590/1516-4446-2014-1507.

Abstract

OBJECTIVE

Inflammatory bowel disease (IBD) is associated with elevated levels of anxiety and depression and a reduction in health-related quality of life (HRQoL). Nonadherence to treatment is also frequent in IBD and compromises outcomes. Religious coping plays a role in the adaptation to several chronic diseases. However, the influence of religious coping on IBD-related psychological distress, HRQoL, and treatment adherence remains unknown.

METHOD

This cross-sectional study recruited 147 consecutive patients with either Crohn's disease or ulcerative colitis. Sociodemographic data, disease-related variables, psychological distress (Hospital Anxiety and Depression Scale), religious coping (Brief RCOPE Scale), HRQoL (WHOQOL-Bref), and adherence (8-item Morisky Medication Adherence Scale) were assessed. Hierarchical multiple regression models were used to evaluate the effects of religious coping on IBD-related psychological distress, treatment adherence, and HRQoL.

RESULTS

Positive RCOPE was negatively associated with anxiety (b = 0.256; p = 0.007) as well as with overall, physical, and mental health HRQoL. Religious struggle was significantly associated with depression (b = 0.307; p < 0.001) and self-reported adherence (b = 0.258; p = 0.009). Finally, anxiety symptoms fully mediated the effect of positive religious coping on overall HRQoL.

CONCLUSION

Religious coping is significantly associated with psychological distress, HRQoL, and adherence in IBD.

摘要

目的

炎症性肠病(IBD)与焦虑和抑郁水平升高以及健康相关生活质量(HRQoL)降低有关。IBD患者治疗依从性差的情况也很常见,这会影响治疗效果。宗教应对在多种慢性病的适应过程中发挥作用。然而,宗教应对对IBD相关心理困扰、HRQoL和治疗依从性的影响尚不清楚。

方法

这项横断面研究连续招募了147例克罗恩病或溃疡性结肠炎患者。评估了社会人口统计学数据、疾病相关变量、心理困扰(医院焦虑抑郁量表)、宗教应对(简易宗教应对量表)、HRQoL(世界卫生组织生活质量简表)和依从性(8项Morisky药物依从性量表)。采用分层多元回归模型评估宗教应对对IBD相关心理困扰、治疗依从性和HRQoL的影响。

结果

积极的宗教应对与焦虑呈负相关(b = 0.256;p = 0.007),也与总体、身体和心理健康HRQoL呈负相关。宗教挣扎与抑郁(b = 0.307;p < 0.001)和自我报告的依从性(b = 0.258;p = 0.009)显著相关。最后,焦虑症状完全介导了积极宗教应对对总体HRQoL的影响。

结论

宗教应对与IBD患者的心理困扰、HRQoL和依从性显著相关。

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