刚被诊断出多发性硬化症患者的应对策略与调整: 心理一致感的中介作用。

Coping strategies and adjustment to multiple sclerosis among recently diagnosed patients: the mediating role of sense of coherence.

机构信息

1 Department of Psychology, University of Torino, Torino, Italy.

2 Cosso Foundation, Torino, Italy.

出版信息

Clin Rehabil. 2017 Oct;31(10):1386-1395. doi: 10.1177/0269215517695374. Epub 2017 Mar 7.

Abstract

OBJECTIVE

To examine the relationship between coping strategies (problem solving, emotional release, and avoidance) and adjustment (health-related quality of life, depression, and affective well-being) in a group of recently diagnosed multiple sclerosis patients (up to three years since diagnosis), and to explore the mediating role of sense of coherence between coping strategies and adjustment.

DESIGN

Cross-sectional.

SETTING

Multiple Sclerosis Clinic Centre.

SUBJECTS

A total of 102 patients (61.8% women; age (years): M = 35.8, SD = 11.9; 95% with a relapsing-remitting form of multiple sclerosis; Expanded Disability Status Scale score, between 1 and 4).

INTERVENTIONS

Not applicable.

MAIN MEASURES

Coping with multiple sclerosis (problem solving, emotional release, and avoidance), sense of coherence, health-related quality of life (SF-12), depression (CES-D), and affective well-being (PANAS).

RESULTS

Problem solving was linked to higher mental health ( β = 0.28) and higher affective well-being ( β = 0.36), emotional release was related to lower depression ( β = -0.22); avoidance was associated to higher mental health ( β = 0.25), higher affective well-being ( β = 0.24), and lower depression ( β = -0.29 ) (all betas were significant at p < 0.05). Sense of coherence mediated the relationship between emotional release and depression (Sobel z-value = -2.00; p < 0.05) and the relationship between avoidance and all the indicators of adjustment (mental health: Sobel z-value = 1.97; depression: Sobel z-value = -2.02; affective well-being: Sobel z-value= 2.05; p < 0.05).

CONCLUSIONS

Emotional and avoidant coping strategies seem to be adaptive among recently diagnosed multiple sclerosis patients. A mediating role between coping strategies and adjustment is played by sense of coherence.

摘要

目的

研究一组新近被诊断为多发性硬化症的患者(诊断后至三年)的应对策略(问题解决、情绪释放和回避)与调整(健康相关生活质量、抑郁和情感幸福感)之间的关系,并探讨应对策略与调整之间的中介作用,由社会认知理论中的“意义感”来解释。

设计

横断面研究。

地点

多发性硬化症诊所中心。

研究对象

共 102 名患者(61.8%为女性;年龄(岁):M = 35.8,SD = 11.9;95%为复发缓解型多发性硬化症;扩展残疾状态量表评分在 1 到 4 之间)。

干预措施

无。

主要措施

多发性硬化症应对方式(问题解决、情绪释放和回避)、意义感、健康相关生活质量(SF-12)、抑郁(CES-D)和情感幸福感(PANAS)。

结果

问题解决与较高的心理健康(β=0.28)和较高的情感幸福感(β=0.36)有关,情绪释放与较低的抑郁有关(β=-0.22);回避与较高的心理健康(β=0.25)、较高的情感幸福感(β=0.24)和较低的抑郁有关(β=-0.29)(所有β在 p<0.05 时均具有统计学意义)。意义感在情绪释放与抑郁(Sobel z 值=-2.00;p<0.05)和回避与所有调整指标(心理健康:Sobel z 值=1.97;抑郁:Sobel z 值=-2.02;情感幸福感:Sobel z 值=2.05;p<0.05)之间的关系中起中介作用。

结论

情绪和回避应对策略在新近被诊断为多发性硬化症的患者中似乎是适应性的。意义感在应对策略与调整之间起着中介作用。

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