Anil Krithika, Garip Gulcan
University of Derby Online Learning, Derby, England, United Kingdom.
University of Derby, Kedleston Road, Derby, England, DE22 1GB, United Kingdom.
BMC Ophthalmol. 2018 Jan 30;18(1):21. doi: 10.1186/s12886-018-0689-2.
Retinitis pigmentosa is a group of genetic progressive retinal dystrophies that may adversely affect daily life. Those with RP should develop adaptive coping strategies to manage their condition. This study investigates the relationship between engaging (ECS) and disengaging coping strategies (DCS), vision-related quality of life (VRQoL), and emotional health, in adults living at home with retinitis pigmentosa.
One hundred and five participants (70 female; mean of 46.98, SD = 13.77) completed a cross-sectional survey. The questionnaire booklet consisted of the Coping Strategies Inventory - Short Form (32 items), the National Eye Institute Visual Functioning Questionnaire 25 (25 items), Marylands Trait Depression Scale (18 items), the Warwick-Edinburgh Mental Well-being Scale (14 items), and the Subjective Happiness Scale (4 items).
Data was analysed with a two-block hierarchical multiple regression, with the first block controlling for the demographic data (age, sex, years since retinitis pigmentosa diagnosis, number of comorbidities, participant-perceived retinitis pigmentosa severity, and knowing RP type) and the second block consisting of primary measures (type of coping strategy, VRQoL, and Emotional Health). Type of coping strategy was found to impact psychosocial variables of VRQoL, not overall VRQoL. These psychosocial VRQoL variables had a positive association with ECS and a negative association with DCS. Emotional Health increased with ECS and decreased with DCS. There was a larger impact of DCS on VRQoL and Emotional Health compared to ECS, that is, VRQoL and Emotional Health decreased more with increasing DCS than VRQoL, and Emotional Health increased with increasing ECS.
In concordance with previous research, ECS increased with increasing VRQoL and DCS decreased with increasing VRQoL. However, the findings also indicated that DCS had a greater impact than ECS on VRQoL and Emotional Health. This suggests that diminishing DCS should be prioritised over developing ECS to positively influence VRQoL and Emotional Health. Further research should investigate the impact of reducing DCS compared to increasing ECS, and how this may influence VRQoL and Emotional Health.
视网膜色素变性是一组遗传性进行性视网膜营养不良疾病，可能对日常生活产生不利影响。患有视网膜色素变性的人应制定适应性应对策略来管理自身病情。本研究调查了居家生活的成年视网膜色素变性患者中，积极应对策略（ECS）和消极应对策略（DCS）、视力相关生活质量（VRQoL）以及情绪健康之间的关系。
105名参与者（70名女性；平均年龄46.98岁，标准差=13.77）完成了一项横断面调查。问卷手册包括应对策略量表简版（32项）、美国国立眼科研究所视觉功能问卷25项版（25项）、马里兰特质抑郁量表（18项）、沃里克-爱丁堡心理健康量表（14项）以及主观幸福感量表（4项）。
数据采用两阶段分层多元回归分析，第一阶段控制人口统计学数据（年龄、性别、视网膜色素变性诊断后的年数、合并症数量、参与者感知的视网膜色素变性严重程度以及是否知道视网膜色素变性类型），第二阶段包括主要测量指标（应对策略类型、VRQoL和情绪健康）。结果发现，应对策略类型会影响VRQoL的心理社会变量，但不影响整体VRQoL。这些心理社会VRQoL变量与ECS呈正相关，与DCS呈负相关。情绪健康随ECS增加而增加，随DCS增加而降低。与ECS相比，DCS对VRQoL和情绪健康的影响更大，即随着DCS增加，VRQoL和情绪健康的下降幅度比VRQoL更大，而随着ECS增加，VRQoL和情绪健康会增加。
与先前的研究一致，随着VRQoL增加，ECS增加，随着VRQoL增加，DCS减少。然而，研究结果还表明，DCS对VRQoL和情绪健康的影响比ECS更大。这表明，为了对VRQoL和情绪健康产生积极影响，应优先减少DCS，而不是发展ECS。进一步的研究应调查减少DCS与增加ECS相比的影响，以及这可能如何影响VRQoL和情绪健康。
