Thakur Elyse R, Sansgiry Shubhada, Petersen Nancy J, Stanley Melinda, Kunik Mark E, Naik Aanand D, Cully Jeffrey A
Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC 152), 2002 Holcombe Blvd., Houston, TX, 77030, USA.
Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
Int J Behav Med. 2018 Feb;25(1):74-84. doi: 10.1007/s12529-017-9663-2.
Guided by the Transactional Model of Stress and Coping, the purpose of this cross-sectional study was to examine clinical factors-demographics, chronic obstructive pulmonary disease (COPD) severity, cognitive/perceptual variables (appraisal and coping)-and their relationship to clinically elevated symptoms of anxiety in a sample of veterans with COPD.
Participants included a sample of veterans with COPD, with or without comorbid congestive heart failure, and clinically significant symptoms of anxiety (n = 172, mean age = 65.3, SD = 8.1), who previously presented to an outpatient VA setting. Participants completed questionnaires examining COPD severity (respiratory impairment and dyspnea- and fatigue-related quality of life); perceptions of a stressor (COPD illness intrusiveness); perceptions of control (locus of health control, mastery over COPD, self-efficacy); coping strategies (adaptive and maladaptive); and anxiety and depressive symptoms.
Multivariable linear regressions revealed that anxiety was positively associated with more maladaptive coping and locus of control (attributed to other people), above and beyond disease severity, demographics, and depressive symptoms.
These findings suggest that cognitive and perceptual factors are concurrent with anxiety; however, longitudinal investigations are needed to fully understand this relationship. Future research should also focus on identifying optimal assessment and treatment procedures when evaluating and treating patients with COPD and symptoms of anxiety.
NCT01149772.
以压力与应对的交互模型为指导，本横断面研究旨在调查临床因素——人口统计学特征、慢性阻塞性肺疾病（COPD）严重程度、认知/感知变量（评估与应对）——以及它们与一组患有COPD的退伍军人中临床上焦虑症状加重之间的关系。
参与者包括一组患有COPD的退伍军人样本，伴有或不伴有合并症充血性心力衰竭，以及临床上显著的焦虑症状（n = 172，平均年龄 = 65.3，标准差 = 8.1），他们之前曾到退伍军人事务部门诊就诊。参与者完成了问卷调查，内容包括COPD严重程度（呼吸功能损害以及与呼吸困难和疲劳相关的生活质量）；对压力源的认知（COPD疾病侵扰性）；控制感（健康控制源、对COPD的掌控感、自我效能感）；应对策略（适应性和适应不良性）；以及焦虑和抑郁症状。
多变量线性回归显示，除了疾病严重程度、人口统计学特征和抑郁症状外，焦虑与更多的适应不良应对方式和控制源（归因于他人）呈正相关。
这些发现表明，认知和感知因素与焦虑同时存在；然而，需要进行纵向调查以充分理解这种关系。未来的研究还应侧重于确定在评估和治疗患有COPD和焦虑症状的患者时的最佳评估和治疗程序。
NCT01149772。
