Siciliano Mattia, Santangelo Gabriella, Trojsi Francesca, Di Somma Carmela, Patrone Manila, Femiano Cinzia, Monsurrò Maria Rosaria, Trojano Luigi, Tedeschi Gioacchino
a Department of Psychology , Second University of Naples , Caserta , Italy.
b Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences , Second University of Naples (SUN) , Naples , Italy.
Amyotroph Lateral Scler Frontotemporal Degener. 2017 Aug;18(5-6):367-377. doi: 10.1080/21678421.2017.1285316. Epub 2017 Feb 10.
Amyotrophic lateral sclerosis (ALS) causes distress in caregivers. The present study aims to examine the association between coping strategies and psychological distress in caregivers of ALS patients.
Coping strategies were assessed in 96 ALS informal caregivers by means of the Coping Inventory for Stressful Situations. Data about caregivers' demographic characteristics, levels of burden, depression and anxiety (psychological distress) were also gathered by standardised questionnaires. Patients' clinical, cognitive and behavioural disturbances were evaluated by ALS specific assessment tools.
Sequential logistic regression analysis showed that emotion-oriented coping strategy was significantly associated with high levels of depressive (p < 0.01) and anxiety (p < 0.05) symptoms and high levels of burden (p < 0.05), after controlling for all other variables. Moreover, a significant relationship of patients' functional dependence levels with burden experienced by caregivers was observed. No relationships were detected between task-oriented and avoidance-oriented coping strategies and caregivers' levels of psychological distress.
The present study supported the mediating effects of coping strategies on intensity of burden, depression and anxiety experienced by ALS caregivers. These findings suggest that interventions aimed at reducing utilisation of maladaptive coping strategies may improve well-being in ALS caregivers, and, possibly, management of symptoms in ALS patients.
肌萎缩侧索硬化症（ALS）给照料者带来困扰。本研究旨在探讨ALS患者照料者的应对策略与心理困扰之间的关联。
通过应激情境应对量表对96名ALS非专业照料者的应对策略进行评估。还通过标准化问卷收集了照料者的人口统计学特征、负担水平、抑郁和焦虑（心理困扰）数据。使用ALS特定评估工具对患者的临床、认知和行为障碍进行评估。
序贯逻辑回归分析显示，在控制所有其他变量后，以情绪为导向的应对策略与高水平的抑郁症状（p < 0.01）、焦虑症状（p < 0.05）以及高水平的负担（p < 0.05）显著相关。此外，观察到患者的功能依赖水平与照料者所经历的负担之间存在显著关系。未发现以任务为导向和以回避为导向的应对策略与照料者的心理困扰水平之间存在关联。
本研究支持应对策略对ALS照料者所经历的负担强度、抑郁和焦虑的中介作用。这些发现表明，旨在减少不良应对策略使用的干预措施可能会改善ALS照料者的幸福感，并可能改善ALS患者的症状管理。
