Reynolds Nina, Mrug Sylvie, Wolfe Kelly, Schwebel David, Wallander Jan
a Department of Pediatrics , University of Alabama at Birmingham , Birmingham , AL , USA.
b Department of Psychology , University of Alabama at Birmingham , Birmingham , AL , USA.
Health Psychol Rev. 2016 Jun;10(2):226-43. doi: 10.1080/17437199.2016.1159142. Epub 2016 Mar 22.
The current systematic review and meta-analysis aimed to assess the strength of the relationships between religious/spiritual coping strategies and psychosocial adjustment and physical health in youth with chronic illness.
Faced with medical stressors and uncertainty about their illness, spiritual beliefs and behaviours are important for youth with chronic illness. Research suggests that some spiritual coping strategies are helpful (positive), while others are not (negative), and these dimensions of spiritual coping are important predictors of functioning among youth with chronic illness.
Fourteen studies, published between 1990 and 2015, met inclusion criteria for the meta-analysis and were analysed using both a fixed effects model and random effects model (REM).
Findings revealed significant, small to moderate associations between negative spiritual coping and more concurrent internalising problems (REM r = .34), lower quality of life (REM r = -.34), and poorer health (REM r = -.08). Under the fixed, but not REM, the combined effects showed small to moderate significant relationships between positive spiritual coping and fewer internalising problems (r = -.19) and better physical health (r = .19).
The results reveal that spiritual coping is an important coping strategy for paediatric patients. Consistent with findings among adults with chronic illness, negative spiritual coping puts paediatric patients at risk for psychosocial maladjustment and poorer health. Intervention research is needed to determine if targeting spiritual coping improves health and psychosocial well-being.
本次系统评价和荟萃分析旨在评估宗教/精神应对策略与慢性病青少年心理社会适应及身体健康之间关系的强度。
面对医疗压力源及其疾病的不确定性,精神信仰和行为对慢性病青少年很重要。研究表明,一些精神应对策略是有帮助的(积极的),而另一些则不然(消极的),并且这些精神应对维度是慢性病青少年功能的重要预测因素。
1990年至2015年间发表的14项研究符合荟萃分析的纳入标准,并使用固定效应模型和随机效应模型(REM)进行分析。
研究结果显示,消极精神应对与更多同时出现的内化问题(随机效应模型r = 0.34)、较低的生活质量(随机效应模型r = -0.34)以及较差的健康状况(随机效应模型r = -0.08)之间存在显著的小到中等程度的关联。在固定效应模型(而非随机效应模型)下,综合效应显示积极精神应对与较少的内化问题(r = -0.19)和更好的身体健康(r = 0.19)之间存在小到中等程度的显著关系。
结果表明,精神应对是儿科患者的重要应对策略。与慢性病成年患者的研究结果一致,消极精神应对使儿科患者面临心理社会适应不良和健康状况较差的风险。需要进行干预研究以确定针对精神应对是否能改善健康和心理社会幸福感。