1 Department of Neurorehabilitation, Libra Rehabilitation Medicine and Audiology, Eindhoven, The Netherlands.
2 Department of Clinical and Medical Psychology, Academic MS Center Limburg, Zuyderland Medical Center, Sittard-Geleen, The Netherlands.
Clin Rehabil. 2018 Jan;32(1):116-126. doi: 10.1177/0269215517718367. Epub 2017 Jul 10.
To investigate the use of coping styles and the relationships linking coping to emotional distress and quality of life in patients with acquired brain injury and multiple sclerosis.
Cross-sectional cohort study of 143 patients with acquired brain injury and 310 patients with multiple sclerosis in the chronic stage. Quality of life was measured with the Life Satisfaction Questionnaire (LiSat-9), coping styles with the Coping Inventory for Stressful Situations (CISS-T, task-oriented; CISS-E, emotion-oriented; CISS-A, avoidance), emotional distress with the Hospital Anxiety and Depression Scale (HADS).
Coping styles did not differ between types of multiple sclerosis and varied only little with regard to severity of disease. In both patient groups, task-oriented coping was most used followed by avoidance and emotion-oriented coping. Patients with multiple sclerosis used all styles to a greater extent. In acquired brain injury, lower CISS-E and lower HADS scores were associated with higher LiSat-9 scores. CISS-E had a direct effect on LiSat-9 and an indirect effect via HADS. In multiple sclerosis, next to lower CISS-E and lower HADS scores, higher CISS-A scores were also associated with higher LiSat-9 scores. CISS-E had an indirect effect and CISS-A had a direct and indirect effect on LiSat-9.
In both patient groups, coping patterns are similar, and emotion-oriented coping negatively influences quality of life. Additionally, in multiple sclerosis, seeking emotional support and distraction (CISS-A) was positively associated with quality of life. Interventions to improve adaptive coping could be organized within a neurorehabilitation setting for both patient groups together.
探讨应对方式在获得性脑损伤和多发性硬化症患者中的应用，以及应对方式与情绪困扰和生活质量之间的关系。
对 143 例获得性脑损伤患者和 310 例多发性硬化症慢性期患者进行横断面队列研究。采用生活满意度问卷（LiSat-9）、应激情境应对量表（CISS-T，任务导向；CISS-E，情绪导向；CISS-A，回避）测量生活质量，采用医院焦虑抑郁量表（HADS）测量情绪困扰。
多发性硬化症的不同类型之间应对方式无差异，且与疾病严重程度的变化很小。在两组患者中，任务导向应对方式使用最多，其次是回避和情绪导向应对方式。多发性硬化症患者使用所有应对方式的程度更高。在获得性脑损伤患者中，CISS-E 和 HADS 评分越低，LiSat-9 评分越高。CISS-E 对 LiSat-9 有直接影响，通过 HADS 有间接影响。在多发性硬化症患者中，除了 CISS-E 和 HADS 评分较低外，CISS-A 评分较高也与 LiSat-9 评分较高相关。CISS-E 对 LiSat-9 有间接影响，CISS-A 对 LiSat-9 有直接和间接影响。
在两组患者中，应对模式相似，情绪导向应对方式对生活质量产生负面影响。此外，在多发性硬化症中，寻求情感支持和分散注意力（CISS-A）与生活质量呈正相关。在神经康复环境中，可以针对两组患者一起组织提高适应性应对的干预措施。
