Porcerelli John H, Cramer Phebe, Porcerelli Daniel J, Arterbery V Elayne
*Department of Psychology, University of Detroit Mercy, MI; †Department of Psychology, Williams College, Williamstown, MA; and ‡Department of Radiation Oncology, Detroit Medical Center, MI.
J Nerv Ment Dis. 2017 Jun;205(6):466-470. doi: 10.1097/NMD.0000000000000674.
A group of 49 patients who had been diagnosed with cancer during the preceding year and who were receiving radiation therapy were assessed for their use of defense mechanisms, as well as for their level of psychological distress. In addition, their utilization of medical services was determined. It was predicted that the use of services that were under the patients' control-namely, requesting extra outpatient visits and making trips to the emergency department-would be related to the patients' use of defense mechanisms, whereas a treatment option not under the patients' control-overnight hospitalization based on physicians' assessment of condition-would not be related to defense use. The findings confirmed the hypotheses. Outpatient visits were strongly predicted by defense use, whereas hospitalization was determined by psychological distress. However, emergency department visits were determined by both defense use and psychological distress. In addition, an interaction between defense and distress was found to predict hospitalization.
一组在前一年被诊断患有癌症且正在接受放射治疗的49名患者,接受了防御机制使用情况以及心理困扰程度的评估。此外,还确定了他们对医疗服务的利用情况。据预测,患者能够控制的服务使用情况——即要求额外的门诊就诊和前往急诊科——将与患者的防御机制使用情况相关,而患者无法控制的治疗选择——基于医生对病情的评估进行过夜住院治疗——则与防御机制的使用无关。研究结果证实了这些假设。防御机制的使用强烈预测了门诊就诊情况,而住院情况则由心理困扰程度决定。然而,急诊科就诊情况由防御机制的使用和心理困扰程度共同决定。此外,还发现防御机制和心理困扰之间的相互作用可以预测住院情况。