Stepleman Lara M, Floyd Rebecca M, Valvano-Kelley Abbey, Penwell-Waines Lauren, Wonn Sarah, Crethers Danielle, Rahn Rebecca, Smith Suzanne
Department of Psychiatry and Health Behavior.
Department of Neuropsychology, Baylor Institute for Rehabilitation.
Rehabil Psychol. 2017 May;62(2):165-177. doi: 10.1037/rep0000126. Epub 2017 Apr 27.
PURPOSE/OBJECTIVE: To develop and test initial validation of a theory-driven quantitative measure of identity reconstruction in patients with multiple sclerosis (MS) based upon previous qualitative research. Research Method/Design: This study uses a cross-sectional survey design, in which 137 patients living with MS were recruited from an outpatient MS Center in the Southeastern U.S. Participants completed demographic items, Identity Reconstruction Assessment Scales (IRAS), Patient Determined Disease Steps, Medical Outcomes Study Measures of Patient Adherence, Chronic Disease Self-Efficacy Scale, Hospital Anxiety and Depression Scale, Leeds MS Quality of Life Questionnaire, MS-Related Stigma Scale, and Posttraumatic Growth Inventory-Short Form.
The IRAS conformed to a 3-factor solution consisting of 23 items accounting for 42.6% of the variance. The 3 factors, labeled as "sustained identity" (α = .84), "reactionary identity" (α = .74), and "integrated identity" (α = .65), were not significantly correlated with each other, necessitating and allowing for independent scoring of the scales. Higher scores on "sustained identity" scale were associated with less anxiety, depression, perceived disability, and MS-related stigma, as well as with increased self-efficacy, treatment adherence, and quality of life. "Reactionary identity" scale was positively correlated with anxiety and MS-related stigma. "Integrated identity" was significantly associated with age and perceived disability.
CONCLUSIONS/IMPLICATIONS: Identity reconstruction provides needed context for understanding adjustment to and living with MS. Examination of the IRAS within a larger sample and in other disease groups can provide additional construct validity evidence. (PsycINFO Database Record
目的/目标：基于先前的定性研究，开发并测试一种理论驱动的多发性硬化症（MS）患者身份重建定量测量方法的初步验证。研究方法/设计：本研究采用横断面调查设计，从美国东南部的一家门诊MS中心招募了137名MS患者。参与者完成了人口统计学项目、身份重建评估量表（IRAS）、患者确定的疾病阶段、医疗结果研究患者依从性测量、慢性病自我效能量表、医院焦虑和抑郁量表、利兹MS生活质量问卷、MS相关耻辱感量表以及创伤后成长问卷简版。
IRAS符合一个由23个项目组成的三因素解决方案，解释了42.6%的方差。这三个因素分别标记为“持续身份”（α = 0.84）、“反应性身份”（α = 0.74）和“整合身份”（α = 0.65），它们彼此之间没有显著相关性，因此需要并允许对量表进行独立评分。“持续身份”量表得分较高与焦虑、抑郁、感知到的残疾和MS相关耻辱感较低相关，同时也与自我效能感、治疗依从性和生活质量提高相关。“反应性身份”量表与焦虑和MS相关耻辱感呈正相关。“整合身份”与年龄和感知到的残疾显著相关。
结论/启示：身份重建为理解对MS的适应和与之共存提供了必要的背景。在更大的样本和其他疾病群体中对IRAS进行检验可以提供额外的结构效度证据。（PsycINFO数据库记录）
