Ben-Gurion University of the Negev.
Soroka Medical Center.
J Clin Psychol. 2018 Jun;74(6):969-988. doi: 10.1002/jclp.22561. Epub 2017 Dec 15.
To examine the associations of daily hassles with the somatic and psychological health of Crohn's disease (CD) patients.
A cross-sectional study of 400 self-selected adult CD patients was performed with completion of demographic, medical, and psychosocial questionnaires: economic status; Patient Harvey-Bradshaw Index of disease activity; Daily Hassles Scale (DHS); Short Inflammatory Bowel Disease Questionnaire (SIBDQ) and Short-Form Health Survey (SF-36 Physical and Mental Health) quality of life measures; Brief Symptom Inventory of psychological stress with summary Global Severity Index (GSI); Family Assessment Device; and List of Threatening Life Experiences. Analyses included correlations, regressions, and Sobel test statistic.
The patients were aged 38.7 ± 14.1 years, 61% female and 67% working. The Patient Harvey-Bradshaw Index was 5.52 ± 4.87. The DHS was 88.0 ± 23.2, similar in men and women, higher in smokers, and increased with greater disease activity (p < .001). The most commonly reported hassles were time, social, and work. DHS had significant negative correlations with age, disease duration, and economic status and positive correlations with GSI, SF-36, and SIBDQ. An increased Daily Hassles score was associated with reduced SIBDQ (p < .001) and SF-36 Mental Health (p < .001) and increased GSI (p < .001) and Patient Harvey-Bradshaw Index (p < .001). This effect of DHS on Patient Harvey-Bradshaw Index was mediated by GSI (Sobel t = 6.09, p < 0.001).
Daily hassles in CD patients are shown for the first time to be associated with increased psychological stress and disease activity and reduced quality of life and lower economic status. This has psychotherapeutic implications.
探讨日常困扰与克罗恩病(CD)患者躯体和心理健康的关系。
对 400 名自我选择的成年 CD 患者进行横断面研究,完成人口统计学、医学和社会心理问卷:经济状况;患者 Harvey-Bradshaw 疾病活动指数;日常困扰量表(DHS);简短炎症性肠病问卷(SIBDQ)和简短健康调查(SF-36 身心健康)生活质量量表;简短症状清单心理压力的总体严重程度指数(GSI);家庭评估工具;以及威胁生命经历清单。分析包括相关性、回归和 Sobel 检验统计。
患者年龄为 38.7 ± 14.1 岁,61%为女性,67%有工作。患者 Harvey-Bradshaw 指数为 5.52 ± 4.87。DHS 为 88.0 ± 23.2,男性和女性相似,吸烟者更高,与疾病活动度增加相关(p<.001)。报告最多的困扰是时间、社会和工作。DHS 与年龄、疾病持续时间和经济状况呈显著负相关,与 GSI、SF-36 和 SIBDQ 呈显著正相关。每日困扰评分增加与 SIBDQ 降低(p<.001)、SF-36 心理健康降低(p<.001)、GSI 增加(p<.001)和患者 Harvey-Bradshaw 指数增加(p<.001)相关。DHS 对患者 Harvey-Bradshaw 指数的影响通过 GSI 介导(Sobel t=6.09,p<.001)。
首次表明 CD 患者的日常困扰与心理压力增加、疾病活动度增加、生活质量降低和经济状况较差有关。这具有心理治疗意义。