Department of Psychiatry, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
Indian J Med Res. 2017 Jun;145(6):786-795. doi: 10.4103/ijmr.IJMR_1927_14.
BACKGROUND & OBJECTIVES: Persons with schizophrenia use various coping strategies to adapt to distressing symptoms as well as to deal with daily stressors. Efforts have been made to explore alternative frameworks of coping using Ways of Coping Checklist (WCC) in persons with schizophrenia. This study aimed to re-analyze (factor analysis) the revised-WCC in Indian patients with residual schizophrenia. The secondary aim of the study was to evaluate the relationship of new framework of coping with psychopathology, disability and quality of life (QOL).
Using a cross-sectional design, 103 patients with residual schizophrenia were assessed on WCC. A principal component analysis with varimax rotation was carried out to determine the factor structure of WCC.
Factor analysis yielded six factors which explained 51.6 per cent of the total variance and had acceptable-to-good internal consistency. Based on the type of items loaded, the six factors were named as follows: active and growth-oriented coping, accepting and fantasizing, reflective and confrontative coping, detachment, seeking social support and negative emotional coping. Patients most often used coping strategy of seeking social support, followed by 'accepting and fantasizing' and 'active and growth-oriented coping'. Correlation analysis showed that those who more often used 'active and growth-oriented coping' had less negative symptoms, lower level of disability and higher spiritual and overall QOL.
INTERPRETATION & CONCLUSIONS: The factor structure of revised-WCC was different among patients with schizophrenia when compared with individuals without mental illness, living in the community. It was evident that use of certain adaptive coping strategies was associated with better QOL and lower level of psychopathology. Our findings provided a framework of coping in patients with residual schizophrenia and suggested that promotion of certain coping strategies might be useful in improving the QOL and reduction of psychopathology in patients with schizophrenia.
精神分裂症患者使用各种应对策略来适应痛苦的症状，并应对日常压力源。已经努力探索使用应对方式检查表（WCC）来替代精神分裂症患者的应对框架。本研究旨在重新分析（因子分析）印度残留型精神分裂症患者的修订版 WCC。该研究的次要目的是评估新的应对框架与精神病理学、残疾和生活质量（QOL）的关系。
采用横断面设计，对 103 例残留型精神分裂症患者进行 WCC 评估。采用主成分分析和方差极大旋转进行因子分析，以确定 WCC 的因子结构。
因子分析产生了六个因子，解释了总方差的 51.6%，具有可接受至良好的内部一致性。根据加载项目的类型，这六个因子分别命名为：积极和成长导向的应对、接受和幻想、反思和应对、超脱、寻求社会支持和消极情绪应对。患者最常使用寻求社会支持的应对策略，其次是“接受和幻想”和“积极和成长导向的应对”。相关分析表明，那些更常使用“积极和成长导向的应对”的患者，其阴性症状较少，残疾程度较低，精神和整体生活质量较高。
与社区中没有精神疾病的个体相比，修订版 WCC 的因子结构在精神分裂症患者中有所不同。显然，使用某些适应性应对策略与更好的生活质量和较低的精神病理学水平相关。我们的发现为残留型精神分裂症患者提供了应对框架，并表明促进某些应对策略可能有助于改善精神分裂症患者的生活质量和减少精神病理学。
