测量患有严重疾病的住院患者的适应性应对方式：应对问卷中的疾病洞察

Measuring Adaptive Coping of Hospitalized Patients With a Severe Medical Condition: The Sickness Insight in Coping Questionnaire.

作者信息

Boezeman Edwin J, Hofhuis José G M, Hovingh Aly, Cox Christopher E, de Vries Reinout E, Spronk Peter E

机构信息

1Section Social and Organizational Psychology, Faculty of Social and Behavioral Sciences, Leiden University, Leiden, The Netherlands.2Department of Intensive Care Medicine, Gelre Hospital Apeldoorn, Apeldoorn, The Netherlands.3Division of Pulmonary and Critical Care Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC.4Department of Social and Organizational Psychology, Vrije Universiteit University Amsterdam, Amsterdam, The Netherlands.5Department of Intensive Care Medicine, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.

出版信息

Crit Care Med. 2016 Sep;44(9):e818-26. doi: 10.1097/CCM.0000000000001743.

DOI:10.1097/CCM.0000000000001743

PMID:27088158

Abstract

OBJECTIVES

Adaptive coping strategies are associated with less psychological distress. However, there is no brief, specific, and validated instrument for assessing adaptive coping among seriously ill patients. Our objective was to examine the validity and patient-proxy agreement of a novel instrument, the Sickness Insight in Coping Questionnaire.

DESIGN

A cross-sectional design which included two related studies.

SETTING

A single university-affiliated Dutch hospital.

SUBJECTS

Hospitalized patients (study 1) and ICU-patients and proxies (study 2).

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Study 1 (n = 103 hospitalized patients) addressed the Sickness Insight in Coping Questionnaire's performance relative to questionnaires addressing similar content areas. Coping subscales of the BRIEF COPE, Illness Cognition Questionnaire, and Utrecht Coping List were used as comparator measures in testing the construct validity of the Sickness Insight in Coping Questionnaire-subscales (fighting spirit, toughness, redefinition, positivism, and non-acceptance). The Sickness Insight in Coping Questionnaire had good internal consistency (0.64 ≤ α ≤ 0.79), a clear initial factor structure, and fair convergent (0.24 ≤ r ≤ 0.50) and divergent (r, ≤ 0.12) construct validity. Study 2 examined the performance of the Sickness Insight in Coping Questionnaire among 100 ICU patients and their close family members. This study showed that the Sickness Insight in Coping Questionnaire has good structural validity (confirmatory factor analyses with Comparative Fit Index > 0.90 and Root Mean Square Error of Approximation < 0.08) and moderate (r, 0.37; non-acceptance) to strong (r, > 0.50; fighting spirit, toughness, redefinition, and positivism) patient-close proxy agreement.

CONCLUSIONS

Overall, the Sickness Insight in Coping Questionnaire has good psychometric properties. ICU clinicians can use the Sickness Insight in Coping Questionnaire to gain insight in adaptive coping style of patients through ratings of patients or their close family members.

摘要

目的

适应性应对策略与较少的心理困扰相关。然而，目前尚无一种简短、特定且经过验证的工具来评估重症患者的适应性应对情况。我们的目的是检验一种新型工具——《应对中的疾病洞察问卷》的效度以及患者与代理人之间的一致性。

设计

一项横断面设计，包括两项相关研究。

设置

一家荷兰大学附属医院。

研究对象

住院患者（研究1）以及重症监护病房患者及其代理人（研究2）。

干预措施

无。

测量指标及主要结果

研究1（n = 103名住院患者）探讨了《应对中的疾病洞察问卷》相对于涉及相似内容领域问卷的表现。在检验《应对中的疾病洞察问卷》各子量表（斗志、坚韧、重新定义、积极态度和不接受）的结构效度时，使用了《简明应对方式问卷》《疾病认知问卷》和《乌得勒支应对清单》的应对子量表作为比较指标。《应对中的疾病洞察问卷》具有良好的内部一致性（0.64≤α≤0.79），清晰的初始因子结构，以及较好的聚合效度（0.24≤r≤0.50）和区分效度（r≤0.12）。研究2考察了《应对中的疾病洞察问卷》在100名重症监护病房患者及其近亲中的表现。该研究表明，《应对中的疾病洞察问卷》具有良好的结构效度（验证性因子分析的比较拟合指数>0.90，近似均方根误差<0.08），以及中等（r = 0.37；不接受）到强（r>0.50；斗志、坚韧、重新定义和积极态度）的患者与近亲代理人之间的一致性。