Sarid O, Slonim-Nevo V, Pereg A, Friger M, Sergienko R, Schwartz D, Greenberg D, Shahar I, Chernin E, Vardi H, Eidelman L, Segal A, Ben-Yakov G, Gaspar N, Munteanu D, Rozental A, Mushkalo A, Dizengof V, Abu-Freha N, Fich A, Odes S
Spitzer Department of Social Work, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
PLoS One. 2017 Feb 28;12(2):e0172779. doi: 10.1371/journal.pone.0172779. eCollection 2017.
To identify coping strategies and socio-demographics impacting satisfaction with life and quality of life in Crohn's disease (CD).
402 patients completed the Patient Harvey-Bradshaw Index, Brief COPE Inventory, Satisfaction with Life Scale (SWLS), Short Inflammatory Bowel Disease Questionnaire (SIBDQ). We performed structural equation modeling (SEM) of mediators of quality of life and satisfaction with life.
The cohort comprised: men 39.3%, women 60.1%; P-HBI 4.75 and 5.74 (p = 0.01). In inactive CD (P-HBI≤4), both genders had SWLS score 23.8; men had SIBDQ score 57.4, women 52.6 (p = 0.001); women reported more use of emotion-focused, problem-focused and dysfunctional coping than men. In active CD, SWLS and SIBDQ scores were reduced, without gender differences; men and women used coping strategies equally. A SEM model (all patients) had a very good fit (X2(6) = 6.68, p = 0.351, X2/df = 1.114, SRMR = 0.045, RMSEA = 0.023, CFI = 0.965). In direct paths, economic status impacted SWLS (β = 0.39) and SIBDQ (β = 0.12), number of children impacted SWLS (β = 0.10), emotion-focused coping impacted SWLS (β = 0.11), dysfunctional coping impacted SWLS (β = -0.25). In an indirect path, economic status impacted dysfunctional coping (β = -0.26), dysfunctional coping impacted SIBDQ (β = -0.36). A model split by gender and disease activity showed that in active CD economic status impacted SIBDQ in men (β = 0.43) more than women (β = 0.26); emotional coping impacted SWLS in women (β = 0.36) more than men (β = 0.14).
Gender differences in coping and the impacts of economic status and emotion-focused coping vary with activity of CD. Psychological treatment in the clinic setting might improve satisfaction with life and quality of life in CD patients.
确定影响克罗恩病（CD）患者生活满意度和生活质量的应对策略及社会人口统计学因素。
402例患者完成了患者哈维 - 布拉德肖指数、简易应对方式问卷、生活满意度量表（SWLS）、简短炎症性肠病问卷（SIBDQ）。我们对生活质量和生活满意度的中介因素进行了结构方程模型（SEM）分析。
该队列包括：男性39.3%，女性60.1%；P - HBI分别为4.75和5.74（p = 0.01）。在非活动期CD（P - HBI≤4）中，两性的SWLS得分均为23.8；男性的SIBDQ得分为57.4，女性为52.6（p = 0.001）；女性报告比男性更多地使用聚焦情绪、聚焦问题和功能失调的应对方式。在活动期CD中，SWLS和SIBDQ得分降低，无性别差异；男性和女性使用应对策略的情况相同。一个SEM模型（所有患者）拟合度非常好（X2(6)=6.68，p = 0.351，X2/df = 1.114，SRMR = 0.045，RMSEA = 0.023，CFI = 0.965）。在直接路径中，经济状况影响SWLS（β = 0.39）和SIBDQ（β = 0.12），子女数量影响SWLS（β = 0.10），聚焦情绪的应对方式影响SWLS（β = 0.11），功能失调的应对方式影响SWLS（β = -0.25）。在间接路径中，经济状况影响功能失调的应对方式（β = -0.26），功能失调的应对方式影响SIBDQ（β = -0.36）。按性别和疾病活动情况划分的模型显示，在活动期CD中，经济状况对男性SIBDQ的影响（β = 0.43）大于女性（β = 0.26）；情绪应对方式对女性SWLS的影响（β = 0.36）大于男性（β = 0.14）。
应对方式的性别差异以及经济状况和聚焦情绪应对方式的影响随CD的活动情况而变化。临床环境中的心理治疗可能会提高CD患者的生活满意度和生活质量。
