Gemmell Leigh A, Terhorst Lauren, Jhamb Manisha, Unruh Mark, Myaskovsky Larissa, Kester Lauren, Steel Jennifer L
Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
Department of Occupational Therapy, University of Pittsburgh School of Health and Rehabilitation Sciences, Pittsburgh, Pennsylvania, USA.
J Pain Symptom Manage. 2016 Dec;52(6):806-812. doi: 10.1016/j.jpainsymman.2016.05.029. Epub 2016 Sep 30.
Living with chronic kidney disease can be stressful and influence an individual's health-related quality of life. Effective coping strategies may reduce stress and improve quality of life in individuals with chronic medical conditions.
Health-related quality of life (HRQOL) is an important outcome for patients living with chronic kidney disease (CKD), and it is necessary to better understand potential gender and racial differences and predictors associated with reduced HRQOL, so that effective interventions can be developed.
Participants included 182 patients with CKD who were administered a battery of questions that included the Medical Outcomes Study Short-Form 36, Perceived Stress Scale, and the Brief COPE. Demographic and disease-specific information was abstracted from the patients' medical record.
No differences by race were observed with regard to stress, quality of life, or coping with the exception that minority patients reported use of religious coping more often (P = 0.001) and had higher levels of energy compared with nonminority patients with CKD (P = 0.27). Women with CKD tended to use self-distraction (P = 0.002), positive reframing (P = 0.035), venting (P = 0.024), and religious coping (P = 0 < 0.001) more often than men. No significant differences in perceived stress or domains of quality of life were observed between men and women with CKD. A link between coping strategies and HRQOL was observed in women (P = 0.001-0.02) but not men. Perceived stress was associated with poorer quality of life for men (P = 0.017 to <0.001) and women (P = 0.001 to <0.001), but more domains of men's quality of life were affected by perceived stress compared with women.
The findings of the study suggest that the wider range of coping strategies used by women may be associated with buffering the link between perceived stress and quality of life. Men with CKD may benefit from interventions that not only reduce stress but also facilitate the use of a broader range of coping strategies to reduce stress and improve quality of life.
患有慢性肾脏病会带来压力，并影响个人与健康相关的生活质量。有效的应对策略可能会减轻压力，改善患有慢性疾病个体的生活质量。
与健康相关的生活质量（HRQOL）是慢性肾脏病（CKD）患者的一项重要指标，有必要更好地了解潜在的性别和种族差异以及与HRQOL降低相关的预测因素，以便制定有效的干预措施。
研究对象包括182名CKD患者，他们接受了一系列问题的询问，这些问题包括医学结局研究简明健康调查量表（Medical Outcomes Study Short-Form 36）、感知压力量表（Perceived Stress Scale）和简易应对方式问卷（Brief COPE）。从患者病历中提取人口统计学和疾病特异性信息。
在压力、生活质量或应对方式方面，未观察到种族差异，但少数族裔患者报告更频繁地使用宗教应对方式（P = 0.001），并且与非少数族裔CKD患者相比，精力水平更高（P = 0.27）。患有CKD的女性比男性更倾向于使用自我分心（P = 0.002）、积极重新评价（P = 0.035）、宣泄（P = 0.024）和宗教应对方式（P = 0 < 0.001）。患有CKD的男性和女性在感知压力或生活质量领域方面未观察到显著差异。在女性中观察到应对策略与HRQOL之间存在关联（P = 0.001 - 0.02），而在男性中未观察到。感知压力与男性（P = 0.017至<0.0
