Malarkey William B, David Prabu, Gouin Jean-Philippe, Edwards Michael C, Klatt Maryanna, Zautra Alex J
Department of Internal Medicine, Clinical Research Center, The Ohio State University, 2115G Dodd Hall, 480 Medical Center Dr, Columbus, OH, 43210, USA.
Department of Communication, Michigan State University, East Lansing, MI, USA.
Int J Behav Med. 2016 Dec;23(6):738-745. doi: 10.1007/s12529-016-9559-6.
Patients with symptoms but without an identified disease are a challenge to primary care providers. A 22-item measure is introduced and evaluated to offer medical care providers with an instrument to assess and discuss possible deficiencies in resilience resources that may contribute to symptoms without identifiable pathology. This instrument highlights psychosocial and lifestyle resources that serve as buffers to life's stressors rather than focusing on stress and its related symptoms.
The measure included items from five resilience domains-relational engagement, emotional sensibility, meaningful action, awareness of self and others, and physical health behaviors (REMAP). Its structure and function were evaluated using two different samples.
Results suggest that scores from the REMAP have reasonable psychometric properties. Higher REMAP scores were predictive of fewer health symptoms in a sample representative of the US population. In a second sample, REMAP was positively associated with perceived resilience, ego strength and mindfulness attention and negatively related to perceived stress, depression, sleep disturbances, and loneliness, providing evidence of convergent and divergent validity. Furthermore, the REMAP scale was sensitive to change following a life style intervention.
This suggests that REMAP can be a useful tool in practice settings for counseling patients with unexplained symptoms. With insight into the biopsychosocial aspect of their symptoms, patients may become more receptive to cognitive behavioral options to improve their resilience resources and lifestyle choices.
对于初级保健提供者而言，有症状但未确诊疾病的患者是一项挑战。引入并评估了一项包含22个条目的测评工具，为医疗服务提供者提供一种手段，以评估和讨论可能导致无明确病理症状的恢复力资源方面的潜在不足。该工具突出了作为生活压力缓冲器的心理社会和生活方式资源，而非专注于压力及其相关症状。
该测评工具包含来自五个恢复力领域的条目——关系参与、情感敏感度、有意义的行动、自我与他人意识以及身体健康行为（REMAP）。使用两个不同样本对其结构和功能进行了评估。
结果表明，REMAP得分具有合理的心理测量学特性。在一个代表美国人群的样本中，较高的REMAP得分预示着健康症状较少。在第二个样本中，REMAP与感知到的恢复力、自我力量和正念注意力呈正相关，与感知到的压力、抑郁、睡眠障碍和孤独感呈负相关，提供了聚合效度和区分效度的证据。此外，REMAP量表对生活方式干预后的变化敏感。
这表明REMAP在实践环境中对于为有不明症状的患者提供咨询可能是一个有用的工具。通过洞察其症状的生物心理社会方面，患者可能会更愿意接受认知行为选择，以改善其恢复力资源和生活方式选择。
