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D 型人格、疾病感知、社会支持与持续性不卧床腹膜透析患者的生活质量。

Type D personality, illness perception, social support and quality of life in continuous ambulatory peritoneal dialysis patients.

机构信息

a Department of Nephrology , The First Affiliated Hospital, Sun Yat-sen University , Guangzhou , China.

b Department of Nursing , The First Affiliated Hospital, Sun Yat-sen University , Guangzhou , China.

出版信息

Psychol Health Med. 2017 Feb;22(2):196-204. doi: 10.1080/13548506.2016.1224371. Epub 2016 Aug 23.

Abstract

The previous studies reported Type D was associated with poor quality of life (QoL), increased psychological distress, and impaired health status in cardiac patients. The aim of this study is to assess the relationships among Type D personality, illness perception, social support, and investigate the impact of Type D personality on QoL in continuous ambulatory peritoneal dialysis (CAPD) patients. Type D personality was assessed by the Chinese 14-item Type D Personality Scale (DS14). Illness perceptions were assessed using the Chinese version of the Brief Illness Perception Questionnaire (B-IPQ). Social support status was assessed by the well-validated social support rating scale (SSRS). Patients' QoL was assessed by using Medical Outcomes Short Form 36 (SF-36), respectively. The Type Ds had significantly lower objective support score (8.18 ± 2.56 vs. 9.67 ± 3.28, p = 0.0001), subjective support score (6.71 ± 2.0 vs. 7.62 ± 1.93, p = 0.0001) and utilization of social support score (6.76 ± 2.0 vs. 7.61 ± 1.94, p = 0.0001) than that of the non-type Ds. Type Ds believed their illness had much more serious consequences (7.67 ± 2.64 vs. 6.27 ± 3.45, p < 0.001), and experience much more symptoms that they attributed to their illness (6.65 ± 2.54 vs. 7.31 ± 2.36, p = 0.023). Significant differences were found between Type Ds and non-Type Ds in PCS (40.53 ± 6.42 vs. 48.54 ± 6.21 p < 0.001) and MCS (41.7 1 ± 10.20 vs. 46.35 ± 9.31, p = 0.012). The correlation analysis demonstrated that Type D was negatively associated with physical component score (PCS) (r = -0.29, p < 0.01), mental component score (MCS) (r = -0.31, p < 0.01), and social support (r = -0.24, p < 0.001). Using multiple linear regression analysis, we found that Type D personality was independently associated with PCS (β = -0.32, p < 0.001) and MCS (β = -0.24, p < 0.001). Type D personality was a predictor of poor QoL in CAPD patients. The current study is the first to identify a strong association among Type D, illness perceptions, social support and QoL in CAPD patients. The worse illness perceptions and lower social support level therefore represent possible mechanisms to explain the link between Type D and poor QoL in CAPD patients.

摘要

先前的研究报告指出,D 型人格与较差的生活质量(QoL)、增加的心理困扰和受损的健康状况有关在心脏病人群中。本研究旨在评估 D 型人格、疾病认知、社会支持之间的关系,并探讨 D 型人格对持续非卧床腹膜透析(CAPD)患者 QoL 的影响。通过使用中文 14 项 D 型人格量表(DS14)评估 D 型人格。使用简明疾病认知问卷(B-IPQ)的中文版评估疾病认知。使用经过充分验证的社会支持评定量表(SSRS)评估社会支持状况。使用医疗结局短式 36 项量表(SF-36)分别评估患者的 QoL。D 型人格患者的客观支持评分(8.18 ± 2.56 比 9.67 ± 3.28,p = 0.0001)、主观支持评分(6.71 ± 2.0 比 7.62 ± 1.93,p = 0.0001)和社会支持利用评分(6.76 ± 2.0 比 7.61 ± 1.94,p = 0.0001)明显低于非 D 型人格患者。D 型人格患者认为他们的疾病有更严重的后果(7.67 ± 2.64 比 6.27 ± 3.45,p < 0.001),并经历更多他们归因于疾病的症状(6.65 ± 2.54 比 7.31 ± 2.36,p = 0.023)。D 型人格患者和非 D 型人格患者在躯体成分评分(PCS)(40.53 ± 6.42 比 48.54 ± 6.21,p < 0.001)和精神成分评分(MCS)(41.71 ± 10.20 比 46.35 ± 9.31,p = 0.012)方面存在显著差异。相关性分析表明,D 型人格与身体成分评分(PCS)(r = -0.29,p < 0.01)、精神成分评分(MCS)(r = -0.31,p < 0.01)和社会支持(r = -0.24,p < 0.001)呈负相关。使用多元线性回归分析,我们发现 D 型人格与 PCS(β = -0.32,p < 0.001)和 MCS(β = -0.24,p < 0.001)独立相关。D 型人格是 CAPD 患者 QoL 较差的预测因子。本研究首次确定了 D 型人格、疾病认知、社会支持与 CAPD 患者 QoL 之间的强烈关联。因此,较差的疾病认知和较低的社会支持水平可能是解释 D 型人格与 CAPD 患者较差 QoL 之间关联的潜在机制。

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